ID #783 Feasibility and Safety of Somato-Cognitive Coordination Therapy for Cerebellar Ataxia Following Pediatric Brain Tumor Treatment
Masanobu Takeuchi, Masahiko Hara, Takashi Matsuzawa, Jun Yamanishi, Masahiro Yoshitomi, Junji Ikeda, Shin-Ichi TsujimotoAbstract
Objectives
Cerebellar ataxia is a disabling sequela of pediatric brain tumor treatment, particularly following posterior fossa tumors, leading to persistent impairments in gait, balance, and speech, with no established rehabilitation strategies. Despite improvements in oncologic outcomes, no evidence-based rehabilitation strategies have been established for this condition. This pilot study evaluated the safety , feasibility, and preliminary therapeutic signals of Somato-Cognitive Coordination Therapy (SCCT), a novel virtual reality–based intervention designed to enhance motor coordination through sensorimotor integration.
Methods
We retrospectively analyzed 12 pediatric patients with cerebellar ataxia who received SCCT at a university hospital between August 2023 and April 2025. SCCT consisted of repetitive reaching tasks using a virtual reality system with limited visual feedback to increase proprioceptive demand and promote sensorimotor integration. Sessions lasted approximately 10 minutes and patients received 1–7 sessions according to clinical tolerance and availability. Outcomes were assessed using the Scale for the Assessment and Rating of Ataxia (SARA), focusing on gait, stance, and speech based on patient-prioritized functional impairments. Changes in SARA subscores before and after intervention were analyzed using paired statistical comparisons.
Results
Twenty-one paired observations were analyzed across 12 patients. SCCT was well accepted by patients and caregivers without treatment-related adverse events. Pooled SARA subscores (gait, stance, speech) improved, with median scores decreasing from 3.0 (interquartile range [IQR], 1.0–4.0) at baseline to 1.0 (1.0–2.0) at follow-up (P < .001). Seven patients improved after a single session, with effects sustained across multiple sessions without deterioration at subsequent clinical follow-up. One patient with persistent cerebellar mutism syndrome demonstrated marked speech improvement (Subscore: 6 to 1) after a single session.
Conclusions
SCCT appears to be a safe, feasible, and potentially effective intervention for cerebellar ataxia in pediatric brain tumor survivors. These preliminary findings provide clinically meaningful signals and warrant prospective controlled trials to confirm efficacy.