Walking over obstacles is tried next. Wooden blocks measuring about six
by twelve inches and two inches thick are stood on edge at intervals of
eighteen inches and the patient walks over them, thus training several
groups of muscles; the blocks are at first set in straight lines, then
in curving patterns. An ordinary octavo book makes a good substitute for
a block.
If the trunk muscles are affected by the ataxia, further exercises are
ordered for them, bending and twisting movements, picking up objects
from the floor, etc. For the hands and arms, which, except in those very
rare cases where the ataxia first shows itself in the upper extremities,
seldom exhibit much incooerdination in the primary and middle stages, the
movements are the picking up of a series of different-shaped small
articles, arranging objects like dominoes, marbles, or the kindergarten
sticks in patterns, bringing the fingers of the two hands one after
another together, or touching a finger to the ear or the nose, at first
with open and then with shut eyes.
With these methods, needing not more than twenty minutes three times a
day, the ataxic symptoms sometimes rapidly diminish.
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