Effect of a specific inpatient multidisciplinary rehabilitation program on postural and gait stability in Huntington's disease – Pilot study

Abstract

Postural and gait instability in Huntington's disease (HD) is an essential part of the motor symptomatology causing falls contributing to morbidity and mortality. Rehabilitation (Rhb) is considered beneficial in stability treatment. However, the number of studies is still limited. This is the first multidisciplinary inpatient study using a specific program aimed at postural and gait stability in HD. We aimed to evaluate the short-and long-term effects of an inpatient multidisciplinary rehabilitation program on postural and gait instability in HD. A sample of 16 HD subjects without severe cognitive deficit or depression were included, 13 subjects completed the full course. They underwent a 3-week specific inpatient rehabilitation focused on stability. The examination was at baseline, after the completion, 1 and 3 months after the rehabilitation. The testing included: gait stability examination (Dynamic Gait Index; DGI), posturography examination of postural stability Limits of Stability on a stable (PSS) and 20% unstable (PSU) platform and the motor function evaluation by Unified Huntington's Disease Rating Scale (UHDRS-TMS). There was a significant improvement in DGI immediately after the Rhb and a significant 3 months lasting improvement in PSS. There was no significant improvement in PSU and UHDRS-TMS. Specific Rhb methods improved postural and gait instability in early- and mid-stage HD patients. The improvement in PSS persisted 3 months. We found no improvement in PSU, which is probably a too difficult test for this degree of stability impairment. The improvement in DGI does not persist after 1 month. This study offers a verified specific Rhb protocol for stability training in HD.