From the Guidelines
Dysmetria should be treated with a focus on physical and occupational therapy to improve coordination, using strategies such as repetitive movements with visual feedback, and addressing the underlying cause when possible, as recommended by the most recent guidelines 1.
Diagnosis and Treatment
Dysmetria is a neurological condition characterized by the inability to accurately control the range and force of movement, resulting in overshooting or undershooting a target when performing voluntary movements. It primarily affects the limbs, causing patients to misjudge distance when reaching for objects or performing tasks requiring precision. Dysmetria is typically caused by damage to the cerebellum or its connecting pathways, which are responsible for coordinating movement and fine motor control. Common causes include stroke, multiple sclerosis, cerebellar tumors, traumatic brain injury, or neurodegenerative diseases.
Treatment Approaches
Treatment focuses on addressing the underlying cause when possible and implementing physical and occupational therapy to improve coordination. Specific exercises that focus on repetitive movements with visual feedback can help patients relearn proper movement patterns. The use of adaptive devices and modifications to the home environment can also help patients manage daily activities more effectively. According to the occupational therapy consensus recommendations for functional neurological disorder 1, strategies such as encouraging normal movement patterns and resting postures, and employing anxiety management and distraction techniques, can be helpful in managing symptoms.
Key Considerations
- Repetitive movements with visual feedback can help patients relearn proper movement patterns.
- Addressing the underlying cause when possible is crucial in the treatment of dysmetria.
- Adaptive devices and home modifications can help patients manage daily activities more effectively.
- Anxiety management and distraction techniques can be helpful in managing symptoms, as recommended by the occupational therapy consensus recommendations for functional neurological disorder 1.
- Intensive task-oriented therapy may improve motor performance and actual use of ataxic limbs in patients with stroke-related ataxia, as suggested by the guidelines for adult stroke rehabilitation and recovery 1.
From the Research
Diagnosis of Dysmetria
- Dysmetria is a condition characterized by impaired coordination and movement, often resulting from damage to the cerebellum or its connections 2, 3.
- The diagnosis of dysmetria typically involves a physical examination and assessment of motor function, including tests of coordination, balance, and movement 2, 3.
- Neuroimaging studies, such as MRI or CT scans, may also be used to rule out other conditions that can cause similar symptoms 2, 3.
Treatment of Dysmetria
- Rehabilitation programs, including physical therapy, occupational therapy, and speech therapy, are often used to treat dysmetria 2, 3, 4.
- These programs aim to improve coordination, balance, and movement, as well as address any related cognitive or communication deficits 2, 3, 4.
- In some cases, the use of limb weights or other devices may be explored as a potential treatment for dysmetria, although the effectiveness of these approaches is still being studied 5.
- Multidimensional physical therapy programs, which incorporate a range of activities and exercises, have been shown to be effective in improving impairments and activity limitations in individuals with cerebellar ataxia 4.
Specific Treatment Approaches
- A case study published in 2018 described a patient with ataxia, dysmetria, and hemiparesis after a stroke, who made significant improvements with a rehabilitation program that included physical therapy and occupational therapy 2.
- Another study published in 2017 reported on a patient with pontine ataxia-dysmetria syndrome, who also made significant improvements with a rehabilitation program that included physical therapy and occupational therapy 3.
- A pilot study published in 2014 explored the use of a systems-level approach to characterizing sensorimotor control in individuals with multiple sclerosis, and found that impairments in sensory feedback control contributed to intention tremor and dysmetria 6.