Cerebellar Reaching Ataxia is Exacerbated by Timing Demands and Assistive Interaction Torques.

Individuals with cerebellar ataxia face significant challenges in controlling reaching, especially when multi-joint movements are involved. This study investigated the effects of kinematic and dynamic demands on reaching using a home-based virtual reality task. Participants with and without cerebellar ataxia reached to target locations designed to elicit a range of coordination strategies between shoulder and elbow joint movements. Compared with control subjects, cerebellar subjects presented greater initial reaching direction errors, larger hand trajectory curvatures, and more variability. Kinematic simulations indicated that early hand movement errors were sensitive to the required onset times and rates of joint movements and were most impaired when opposite direction joint movements were required (e.g., elbow extension with shoulder flexion). Dynamic analysis revealed that cerebellar participants' movements were more impaired in reaching directions where interaction torques would normally assist the desired elbow and shoulder movements. These reach directions were also those that required joint movements in opposite directions. Overall, our data suggest that reaching deficits in cerebellar ataxia result from 1) the early-phase motion planning deficits that are exacerbated by stringent timing coordination requirements and 2) the inability to compensate for interaction torques, particularly when they assist the intended movement.