A single case study of ataxia treated with manual therapy…
An early 60-ish years old patient came in with 2 disabilities. They are:
1. Unsteady gait
2. Trouble of 8/10 Vas scale for sit to stand
These problems been with the patient for the last 3 years plus.

Clinical examination shown:
1. Wide base gait
2. Can’t perform single leg stand
3. Can’t perform modified rhomberg.
4. Positive signs of dysmetria with finger to nose and heel shin sliding tests.
5. Manual listening to posterior cranium and cranial mechanic flexion dysfunction
6. no other upper motor neurons signs

Clinical reasoning:
Patient presented with signs of cerebellar lesions from the clinical examination.
Treatment will be to:
1. Refer to neurologist for further examination
2. Neurology rehab to improve balance and motor control.
3. Cranial manual therapy to improve the cranium mechanic.

Treatment prescribed:
1st session :Cranial manual therapy. During the session, patient reported warm in the tummy and numbness in both arms which patient did complain of when sleeping.
She was also advised to seek consultation from a neurologist.

Outcome from 1st treatment after 1 week:
1.patient reported that her gait has improved by 50%. Her children commented that she can walk straighter with better legs placement.
As for sit to stand, she doesn’t have any more problem
2. Single leg stance was possible for 4 sec.
3. Dysmetria signs also have slight improvement.
4. She also stopped having the warm feeling in her tummy and numbness in her hands at night.