MODERN APPROACHES TO THE DIFFERENTIATED ASSESSMENT OF COORDINATION DISORDERS IN PATIENTS WITH ACUTE CEREBELLAR ATAXIA: A COMPARATIVE ANALYSIS OF THE SARA AND ICARS SCALES
DOI:
https://doi.org/10.32782/health-2026.1.30Keywords:
cerebellar ataxia, physical therapy, neurorehabilitation, SARA scale, ICARS, functional independenceAbstract
The article provides a comprehensive theoretical and analytical study of modern approaches to the differentiated assessment of coordination disorders in patients with acute cerebellar ataxia. The relevance of the problem is due to the complex neural organization of the cerebellum, which contains about 80% of all CNS neurons, and the high risk of functional maladaptation of patients in the early period of the disease. This requires accurate objectification of motor deficits to predict recovery potential and effectively plan rehabilitation. The work aims to conduct a systematic comparative analysis of the psychometric characteristics and clinical suitability of two leading instruments: the Scale for the Assessment and Rating of Ataxia (SARA) and the International Cooperative Ataxia Rating Scale (ICARS). The research methodology is based on a systematic analysis of 30 scientific sources indexed in the international databases PubMed, Scopus, and Web of Science for the period 1997–2025. The study evaluates construct validity, internal consistency (Cronbach’s α coefficient), inter-rater reliability (ICC), sensitivity to minimal clinically important differences (MCID), and correlation with functional independence according to the Barthel Index. It was established that the SARA scale demonstrates exceptional internal consistency (α= 0.94–0.98) and high reliability (ICC = 0.92–0.99). Due to its concise structure (8 items), the average duration of the examination is 6.1 ± 1.4 minutes, which is 3.5 times faster than ICARS (21.4 ± 3.5 min). This makes SARA an optimal tool for daily clinical monitoring in the acute phase, as it minimizes the impact of the patient's physical fatigue on the test results. SARA has been proven to be a sensitive predictor of fall risk: a threshold value of 12 points is associated with critical gait instability. The ICARS scale, with its 19 items, provides a deeper domain differentiation of postural, kinetic, speech, and oculomotor disorders, which is indispensable for initial neurophysiological profiling. Both scales show a high correlation with daily activity indicators (ρ from -0.79 to -0.81), but SARA is more sensitive to short-term changes (MCID 1.0–1.5 points). A strategy for the differentiated use of scales depending on the stage of rehabilitation is substantiated to increase the objectivity of monitoring and individualize physical therapy programs
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