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AUTUMN 2024 InTouch | 17 foot-orthotics (AFOs) may facilitate mobility in certain cases. It is important to monitor for the development of spasticity and contractures (fixed tightening of muscles or tendons). Nonpharmacologic interventions, such as stretching and/or splinting, are usually considered before pharmacologic interventions. If pharmacologic management is necessary, local intervention (such as Botox injections) is preferred over systemic therapy (like muscle relaxers) when possible. As dysarthria (slurred speech) is a common symptom of FA, deliberate interventions to improve the communication skills of listeners (family members / caregivers) including focused attention and a quiet environment, should be discussed. Regular testing of hearing and vestibular function is also recommended. Remote-microphone listening devices may be useful if hearing loss is present. Regular monitoring for the development of bladder spasticity is recommended, as it can lead to urinary retention and recurrent urinary tract infections. Medications may be used for spastic bladder conditions. Some individuals with significant urinary retention may need to undergo intermittent catheterization, which is preferred over an indwelling catheter when possible. Adults with FA who are concerned about sexual function should discuss with their physician potential ways to manage erectile dysfunction or inadequate vaginal lubrication. Individuals with FA should pay attention to cardiac symptoms such as chest pain or palpitations (heart skipping beats or speeding up). Regular consultation with a cardiologist is crucial in monitoring the development of heart failure and/or arrhythmias. Spinal examination should be done regularly with a physiotherapist or orthopaedic FRIEDREICH ATAXIA Continued over ... Friedreich’s Ataxia Over time, symptoms get progressively worse and new symptoms can develop. Symptoms can present as: Source: Cleveland Clinic. Difficulty standing, walking and/or running. Involuntary jerking movements. Fatigue. Slow or slurred speech. Difficulty swallowing. Hearing loss. Muscle tightness. Vision loss. Scoliosis (curvature of the spine). Loss of sensation starting in legs and spreading to arms and abdomen.

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