**4. Final remarks and recommendation**

Although supportive care is necessary to manage the symptoms, there is currently no treatment to halt the disease's progression. Issues with balance, poor voluntary movement coordination, double vision, slurred speech, and difficulties swallowing are among of the condition's most prevalent symptoms. Individuals may also experience stiffness and a loss of sensation resembling Parkinson's or multiple sclerosis.

A variety of rehabilitation programs may be helpful for ataxia patients. Physiotherapy can preserve muscle tone, improve strength and mobility overall, and stop joints from dislocating. Patients who need assistance utilizing adaptive equipment like a wheelchair, cane, or walker can benefit from occupational therapy. Speech and language therapy can help with swallowing and speech improvement. Other forms of therapy and treatment can include medical or pharmaceutical, healthy eating, getting enough sleep, conducting education, biofeedback, yoga, and surgery, among others. Adaptive physical activity, occupational therapy, and physical therapy are three professions that have a lot in common. They often practice the same abilities and clearly understand the importance of the underlying neuromuscular systems that regulate how motions are performed.

The APA intervention is described as a rehabilitation program as opposed to "therapy." Most rehabilitation methods are derived from basic physical activities like aerobic, muscle- and bone-strengthening, balancing, and flexibility exercises. Basic elements of physical activity are included even while utilizing exercise equipment, such as a treadmill, which is an aerobic/cardiovascular workout. People with severe ataxia may benefit from overground walking, trunk stabilization exercises, functional manipulative skills, sports, and leisure activities to help them improve their balance, gait, function, motor coordination, trunk, and movement performance.

The outcomes of an intervention training program are significantly influenced by its length. Adults with severe ataxia may benefit from a 6-month planned physical activity and focused training program since it will improve their general health by boosting their fitness levels, balance, and strength. Ataxia patients may become more involved in community outdoor activities, which will help them integrate with people who do not have disabilities, increase their physical fitness so they can manage daily tasks more easily, and adopt a happier, healthier lifestyle.

Susruta, Hippocrates, and Galen's contributions to the notion that *"exercise is medicine"*, along with the concept's historical context, show that the foundations for the exercise prescription for health and disease prevention has roots that go back more than two millennia in antiquity. Exercise and medical experts should be aware that Susruta, an Indus Valley physician who lived more than 2.5 millennia ago, was the first person to prescribe moderate daily exercise for this reason. They should also be aware that the first "recorded" physician to recommend writing exercise for a patient with a

disease (consumption) was Hippocrates of Greece. He is widely regarded as the "father of medicine". Last but not least, Galen's influence led to the promotion of exercise for health benefits and to lessen the consequences of disease. Up until the beginning of the 16th century, he used exercise to cure patients suffering from a range of maladies [51]. However, current studies with a strong evidence-based data also indicate the advantages of physical activity for both physical and mental health [52, 53].

According to the results of other studies, adapted physical exercise and ataxia are associated with positive health outcomes that support an active lifestyle. The use of personalized physical activity-specific therapies to a larger sample of children, adolescents, and adults is also required, while taking sociocultural, gender, and age factors into consideration. Research is still needed to determine the number and length of treatments required to provide a higher chance of improvement and a higher chance that changes will last. Long-term research examining the best physical activity therapies for children and adolescents with different genetic ataxias are lacking.

Future research will be needed to maintain the advantages, determine the frequency that is most effective, as well as the dosage and delivery method. Ataxia patients can benefit from any sort or amount of intervention, according to this review of the domain of interventions. Due to the complexity of the disease and the unique characteristics, it is required to provide particular diagnoses, symptoms, or "severity" while conducting research in this population. This is significant because, while an intervention might be helpful for a population with ataxia that shares the same features (for example, speech issues), it might not be helpful without modifications for other individuals who have other characteristics (for example, issues other than speech issues).

The findings of this evaluation of the available literature support the necessity for further research into the efficacy of APA treatments for children and adolescents with generative ataxia. In order to better understand the effectiveness and safety of treatments for degenerative ataxia, longitudinal studies are also necessary in this field of research. And finally, the multidisciplinary team is always undeniably important in diagnosing and treating patients with ataxia. Ataxia patients typically receive reviews many times a year, ideally from a specialized team that comprises a neurologist, an advanced palliative care nurse, and, as necessary, additional medical professionals like psychiatrists, physiatrists, social workers, and others.

Adaptive physical activity intervention, occupational therapy, physiotherapy, speech and language therapy (for both feeding and communication), and other interventions can all be very helpful at different periods in the patient's life.

*Adapted Physical Activity and Ataxia DOI: http://dx.doi.org/10.5772/intechopen.111792*
