Hard to get up and down with floor likes idea of chair yoga, Lower body and upper body have coordination issues and no pain. She notices weakness that is fading slowly but has moments with her dizziness. Her back is fine. Walks regularly. The dizziness is a caution to be addressed as we go since her triggers are varied.

Her energy is good , can wain in evening. Was very regular until last yrs with bed and wake ie 5am -10pm. She has a tendency to stay up later and wake later. Is this a problem -she doesn’t know.

Emotionally she is pretty even, she experiences moments and short periods of depression that are normal to her for where she is. She deals with it in her way-call someone and process, go for a walk or something else. Recently she has noticed she is processing some triggers that are bringing up what she believes are repressed memories.

She is part of no religion but aligns with Buddhism and Native American spiritual traditions.
She practices regular meditation (focus on breath and or sensation and Buddhist)

She believes her closest qualities are patience, positivity and empathy. She derives peace from nature, family and friends. She Presents as an intellectual and wise woman.

Dharana is the binding of the mind to one place, object or idea. Focus for the Cerebellar ataxic client is key. First to help coordinating movement and training the mind for her condition but for an elderly person who may forget things. Sutra 3.1

As above Sutra 1.14 Practice becomes firmly grounded when well attended to for a long time, without break and in all earnestness. This applies to all clients perhaps but here we have studies showing that irregular infrequent sessions are not very useful compared to regular frequent sessions.

Santosha 2:42 With her balance and security in her body movements slipping away it is important to establish oneself in Santosha. This also reflects world philosophy of being in the moment and finding contentment or acceptance.

Milne SC, Corben LA, Roberts M, et al. Rehabilitation for ataxia study: protocol
for a randomised controlled trial of an outpatient and supported home-based physiotherapy programme for people with hereditary cerebellar ataxia. BMJ Open 2020;10:e040230. doi:10.1136/ bmjopen-2020-040230
A prospective study of 30 weeks comparing standard care to a 30 week combined outpatient and home-based rehabilitation programme. Cost effective analysis is interesting
Gupta A, Prakash NB, Rahman H. Rehabilitation in ataxia. Indian J Phy Med Rehab 2023;33:21-9.
An article reviewing what is known to this point regarding types of ataxia, their evaluation and treatments.
Miyai, I MD,PhD et al Cerebellar Ataxia Rehabilitation Trial in Degenerative Cerebellar Diseases. Neurorehabilitation and Neuronal Repair 26(5) 515-522
Research purpose to investigate short- and long-term effects of intensive rehabilitation on ataxia, gait, and activities of daily living (ADLs) in patients with degenerative cerebellar disease.

I am seeing this client tomorrow after our session.

• Check in, centering, balanced hatha yoga set considering contraindications, relaxation (with imagery as appropriate),
• Balanced pranayama considering contraindications, meditation/centering.
• Include at least one suggestion from Karma, Bhakti, Raja, or Jnana Yoga tailored for this client.