Feasibility and Safety of Somato-Cognitive Coordination Therapy for Cerebellar Ataxia Following Pediatric Brain Tumor Treatment.
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BACKGROUND: Cerebellar ataxia after pediatric brain tumor treatment can cause persistent gait, balance, and speech impairment, yet no established rehabilitation strategy exists. Somato-cognitive coordination therapy (SCCT) is a virtual reality-guided intervention designed to promote sensorimotor integration through visually constrained reaching tasks. We evaluated the safety, feasibility, and preliminary functional observations of SCCT in this population. METHODS: This single-center retrospective pilot study included 12 consecutive pediatric patients with cerebellar ataxia following brain tumor treatment who underwent outpatient SCCT between August 2023 and April 2025. SCCT sessions comprised approximately 10 min of alternating reaching tasks with limited visual feedback. Safety, acceptability, and changes in routinely documented selected scale for the assessment and rating of ataxia (SARA) subscale scores (gait, stance, and speech) were reviewed. RESULTS: Patients received a median of 1 SCCT session (range, 1-7). No serious adverse events occurred. Although two patients reported transient fatigue, all respondents expressed willingness to continue, and 11 patients (92%) spontaneously described the intervention as enjoyable. Preliminary functional changes were observed even after a single 10-min session. The median pooled SARA subscale score showed a statistically significant reduction from 3.0 [interquartile range, 1.0-4.0] to 1.0 [1.0-2.0] (p < 0.001). One patient with cerebellar mutism showed speech-score reduction accompanied by longitudinal diffusion tractography changes. CONCLUSIONS: SCCT appeared feasible and was not associated with serious adverse events in this retrospective pilot cohort. Exploratory functional observations warrant further evaluation in prospective randomized controlled trials to evaluate therapeutic efficacy and long-term durability.