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medRxiv PreprintsInternational3 November 2026

Challenges in Quantifying Upper Extremity Dysmetria in the Scale for the Assessment and Rating of Ataxia (SARA)

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Background Assessments of upper extremity control in ataxia are susceptible to measurement error and inherent variability. Objectives Quantify trial-to-trial variability in the Scale for the Assessment and Rating of Ataxia (SARA) nose-to-finger (NTF) and finger chase (FC) tasks, and test agreement between scores derived from live assessment and retrospective video review. Methods 17 patients with cerebellar ataxia were video-recorded performing tasks behind a transparent, calibrated 1-cm grid. NTF tremor amplitude and FC undershoot/overshoot distance derived from live scores were compared with
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