A new case report has observed that physical therapy using proprioceptive neuromuscular facilitation (PNF) stabilization techniques improved walking and reduced symptoms of ataxia in a patient with Friedreich ataxia (FA).

The case report, published in Vojnosanitetski Pregled, offers preliminary guidance for physical therapists who work with patients with FA.

“Most studies have shown a reduction in ataxia symptoms due to the use of balance exercises, but there is insufficient high-quality evidence to form clear recommendations and guidelines for clinical practice,” the authors wrote. “We present the successfully performed multicomponent physical therapy intervention involving PNF stability exercises in patients with FA that could improve the clinical practice of such a rare disease.”

The patient was a 26-year-old woman diagnosed with FA at the age of 21 years who presented with generalized ataxia and an inability to walk independently. She had no family history of FA.

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During an annual 3-week inpatient stay, she completed a neurorehabilitation program specifically focused on PNF stabilization, walking, and proprioceptive exercises. She practiced a variety of individual exercises aimed at improving general muscle strength and endurance, posture control, walking, proprioceptive awareness, and flexibility.

At the end of the program, the patient reported better endurance with standing and walking with support as well as improved locomotion.

Given the lack of studies to date on the effectiveness of PNF stabilization techniques in helping patients with FA, the authors consider the results noteworthy and recommend using these techniques in the short-term rehabilitation of these patients.

They caution that there has been no long-term follow-up of this patient and it is a single case report, thus the results cannot be generalized. However, the encouraging results suggest that future studies on rehabilitation and monitoring patients after discharge will provide greater insight into the durability of patient outcomes.


Samardžić V. Efficiency of a 3-week multicomponent rehabilitation on improving the function in a patient with Friedreich’s ataxia: a case report. Vojnosanit Pregl. 2023;80(2):182-187. doi:10.2298/VSP220209027S