Maximizing Functional Recovery

To the Editor: I read with great interest and pleasure the recent Update by Amy Bastian entitled “Mechanisms of Ataxia” (June 1997), and I would like to pose a philosophical question and express a personal point to the author and the readers of the article. In her summary, Dr Bastian stated, “…it could be reasoned that treatments focusing on strategies to reduce the complexity of a movement by minimizing the number of moving joints or by stabilizing against the inertial effects of limb movement will improve movement.” My question is: When examining a patient with ataxia during those early months of rehabilitation (a patient who does those compensations anyway, without our “help”), should we be satisfied, or should we try to utilize the patient's remaining potential to maximize the plasticity of the central nervous system?

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