Occupational Therapy (OT)

OT helps people carry out their daily activities with greater autonomy and quality of life.

Whether it's getting dressed, eating, writing, cooking, or using a cell phone—all of these can be more difficult for those living with ataxia. OT can help!

Occupational therapist doing motor coordination exercises with a patient.

The importance of Occupational Therapy in cerebellar ataxias

Occupational Therapy (OT) is a therapeutic approach focused on promoting functional autonomy through the adaptation of activities and the development of motor, cognitive, and psychosocial skills.

In the context of ataxias—which affect motor control, balance, and coordination—OT is essential to help the patient maintain or regain the ability to carry out activities of daily living (ADLs) with greater safety and independence.

Individualized and Goal-Oriented Approach

OT intervention in ataxia must be individualized, based on a thorough functional assessment and the personal goals set collaboratively with the patient. According to the specific difficulties identified, the occupational therapist designs and implements personalized strategies.

Specific Interventions

Gait and Balance: For patients with gait ataxia (walking instability), OT may include gait training using assistive devices (walkers, canes) and functional exercises aimed at improving balance.
Transfers: Instruction and training are provided to safely perform transfers (e.g., from a wheelchair to a bed or toilet).
Fine Motor Coordination: Exercises and specific activities are proposed to improve fine motor coordination, which is essential for tasks such as handwriting or manipulating small objects (like using a cellphone or buttoning clothes).
Task-Oriented Functional Training: Involves intensive and specific practice of functional tasks that are relevant to the individual, such as dressing, eating, and personal hygiene (e.g., bathing).

Adaptations and Assistive Technology

OT frequently incorporates environmental and task adaptations, as well as Assistive Technology, to enhance the patient’s autonomy. Examples include:

Replacing a manual toothbrush with an electric one in cases of impaired motor coordination.
Using utensils with thickened handles, adapted cups with handles, or pens with special grips.
Implementing assistive writing or communication devices.

Risk Prevention

To prevent falls (a high risk in people with ataxia), OT provides guidance on:

Environmental adaptation (e.g., installing grab bars, removing loose rugs and obstacles, improving lighting—especially at night).
Safe movement techniques.

Fatigue Management

Given that fatigue is a common symptom in ataxia, OT addresses this by:

Helping with the planning and organization of daily routines to optimize energy use.
Teaching task prioritization strategies and incorporating strategic rest breaks.

Communication (Dysarthria)

In interprofessional collaboration—especially with speech therapy—OT can assist with access and training in the use of:

Communication boards.
Augmentative and Alternative Communication (AAC) devices, such as specialized software installed on tablets.

Psychosocial Support and Participation

OT also provides emotional support and encourages patient participation in social, occupational (work, school), and leisure activities, adapting them as needed to enable engagement despite limitations.

In short, there are many strategies that can be adopted to give patients with ataxia a better quality of life, while science continues to pursue a cure or disease-modifying treatments.