A lack of normal adjustment of muscular action so that the intended movement of the limb or other part is not made smoothly and harmoniously, and does not accurately achieve its objective. If the abnormality is hypermetric, the condition is referred to as ataxia. If it is inclined to weakness, e.g. knuckling at the turn, stumbling, failure to flex limbs properly, or to misdirection as in a proprioceptive deficit, it is called incordination . The judgment is best made with the animal going at a good pace, preferably unrestrained, and on level going. A number of sophisticated techniques are available for the examination of the gaits of racing horses. As affecting sphincters, especially of the alimentary tract, the term is used alternatively to achalasia.

Causes

Some of the common causes of Incordination may include:

• Transient ischemic attack (TIA)
• Stroke
• Multiple sclerosis
• Post-infectious condition
• Congenital cerebellar ataxia

Treatment

Adaptive robot training for the treatment of incordination in Multiple Sclerosis. BACKGROUND: Cerebellar symptoms are extremely disabling and are common in Multiple Sclerosis (MS) subjects. In this feasibility study, we developed and tested a robot therapy protocol, aimed at the rehabilitation of incoordination in MS subjects. METHODS: Eight subjects with clinically defined MS performed planar reaching movements while grasping the handle of a robotic manipulandum, which generated forces that either reduced (error-reducing, ER) or enhanced (error-enhancing, EE) the curvature of their movements, assessed at the beginning of each session. The protocol was designed to adapt to the individual subjects' impairments, as well as to improvements between sessions (if any). Each subject went through a total of eight training sessions. To compare the effect of the two variants of the training protocol (ER and EE), we used a cross-over design consisting of two blocks of sessions (four ER and four EE; 2 sessions/week), separated by a 2-weeks rest period. The order of application of ER and EE exercises was randomized across subjects. The primary outcome measure was the modification of the Nine Hole Peg Test (NHPT) score. Other clinical scales and movement kinematics were taken as secondary outcomes. RESULTS: Most subjects revealed a preserved ability to adapt to the robot-generated forces. No significant differences were observed in EE and ER training. However over sessions, subjects exhibited an average 24% decrease in their NHPT score. The other clinical scales showed small improvements for at least some of the subjects. After training, movements became smoother, and their curvature decreased significantly over sessions.

CONCLUSIONS: The results point to an improved coordination over sessions and suggest a potential benefit of a short-term, customized, and adaptive robot therapy for MS subjects.