Abstract
Objective: To assess effects of a two year intensive, multidisciplinary rehabilitation program for patients with early- to mid-stage Huntington’s disease. Design: A prospective intervention study. Setting: One inpatient rehabilitation center in Norway. Subjects: 10 patients, with early- to mid-stage Huntington’s disease. Interventions: A two year rehabilitation program, consisting of six admissions of three weeks each, and two evaluation stays approximately three months after the third and sixth rehabilitation admission. The program focused on physical exercise, social activities, and group/teaching sessions. Main outcome measures: Standard measures for motor function, including gait and balance, cognitive function, including MMSE and UHDRS cognitive assessment, anxiety and depression, activities of daily living (ADL), health related quality of life (QoL) and Body Mass Index (BMI). Results: Six out of ten patients completed the full program. Slight, but non-significant, decline was observed for gait and balance from baseline to the evaluation stay after two years. Non-significant improvements were observed in physical QoL, anxiety and depression, and BMI. ADL-function remained stable with no significant decline. None of the cognitive measures showed a significant decline. An analysis of individual cases revealed that four out of the six participants who completed the program sustained or improved their motor function, while motor function declined in two participants. All the six patients who completed the program reported improved or stable QoL throughout the study period. Conclusion: Our findings suggest that participation in an intensive rehabilitation program is well tolerated among motivated patients with early to mid-stage HD. The findings should be interpreted with caution due to the small sample size in this study.
Highlights
There has been a growing interest in studying effects of rehabilitation in patients with Huntington’s disease (HD)
Non-significant improvements were observed in physical quality of life (QoL), anxiety and depression, and Body Mass Index (BMI)
An analysis of individual cases revealed that four out of the six participants who completed the program sustained or improved their motor function, while motor function declined in two participants
Summary
There has been a growing interest in studying effects of rehabilitation in patients with Huntington’s disease (HD). Zinzi et al [5] described that early to mid-stage HD patients were able to preserve or improve cognitive and motor function after participating in a two year intensive multidisciplinary rehabilitation program that included six in-patient stays, of three weeks each, in a rehabilitation center[5]. Participants and their caregivers reported improvement in physical function, swallowing, balance, increased independence, mood, less apathy and improvement in social relations[6]. A pilot study of a nine months multidisciplinary rehabilitation program, consisting of weekly training sessions, home-based exercises and occupational therapy, compared with a control group of early to middlestage HD patients, suggest that multidisciplinary rehabilitation has therapeutic benefits and is well tolerated[9]
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