Dr Sarah Milne - Friedreich's Ataxia & the cerebellum

Apr 29, 2024

Dr. Sarah Milne, an expert in hereditary cerebellar ataxias and coordinator of the Friedreich's Ataxia Clinic in Melbourne, dives into the complexities of Friedreich's Ataxia, discussing its unique challenges and the importance of personalized rehabilitation strategies. She shares insights from her PhD research on innovative approaches to treatment, including the efficacy of aquatic physiotherapy. The conversation highlights the delicate balance between adaptation and compensation, revealing real-life implications for improving patient quality of life.

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Intro

00:00 • 2min

Navigating Ataxia: From Clinic to Research

01:43 • 7min

Rehabilitation Challenges in Friedreich's Ataxia

08:36 • 27min

Understanding Exercise in Rehabilitation: Efficacy, Effectiveness, and Ethical Considerations

35:12 • 4min

Exploring the Benefits of Aquatic Physiotherapy in Rehabilitation

39:12 • 3min

Navigating Adaptation and Compensation in Neurodegenerative Conditions

42:14 • 4min

This month we are chatting with Dr. Sarah Milne from Murdoch Children’s Research Institute who is also the Coordinator of the Friedreich's Ataxia Clinic at Monash Health in Melbourne, Australia. Sarah is an expert in hereditary cerebellar ataxias and after completing her PhD in 2018 she is trying to bolster the evidence base about the right rehab for people with Friedreich’s Ataxia.

This episode will appeal to people treating Friedreich’s Ataxia or any of the inherited cerebellar ataxias, and to anyone who sees people with cerebellar pathology. Also of interest are the chats about challenges of rehabilitation research. The audio quality in this episode isn’t up to our usual standard with a lot of static happening – sorry!

2.01 Intro & career pathway

4.38 Friedreich’s ataxia

7.00 How is Friedreich’s ataxia different to the hereditary cerebellar ataxias?

8.36 Phenotypes in neurological conditions and the RCT paradigm

11.20 PhD results

15.02 State of the Friedreich’s ataxia evidence

16.49 Ataxia outcome measures

20.03 Ataxia assessment

24.25 Compensation vs optimal cerebellar functioning

27.00 What can imaging tell us about cerebellar conditions?

29.55 Treatment

36.16 Efficacy vs Effectiveness, challenges of rehab trials

39.23 Aquatic physio for this population

41.43 Episode reflection

Links
Research Gate
PhD - 4 studies – Pilot rehabilitation trial for people with Friedreich’s Ataxia. Clinical audit of LL spasticity relationship with ataxia severity & function. Sensitivity of balance, gait measures and instrumented measures of gait & balance change over time.

University of Melbourne profile

Articles discussed:
Brain Changes Associated with Postural Training in Patients with Cerebellar Degeneration

Home aerobic training for cerebellar degenerative diseases: a randomized controlled trial

Cycling regimen induces spinal circuitry plasticity and improves leg muscle coordination in individuals with spinocerebellar ataxia

Predictors of loss of ambulation in Friedreich's ataxia

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Like our podcast and want to support us?
Share the show with your friends & colleagues, give us a rating on your podcast platform or Buy us a coffee. Matt & Erin run the podcast out of their own time and resources. We'd love to update our recording equipment & cover our podcast publishing costs. Buy us a coffee if you can.