Feasibility and Safety of an Aquatherapy Program in Mid- to Late-Stage Huntington Disease

Abstract

Background: The progressive motor dysfunction and cognitive impairment associated with mid- to late-stage Huntington Disease (HD) renders few exercise programs amenable for use in this population. Exercise may slow the symptomatic progression of HD, therefore appropriate programs should be available to those with advanced disease. The pool, with a low risk of falling, boasts an appropriate environment to support choreic limbs. The purpose of this qualitative questionnaire-based study was to assess the feasibility and safety of aquatherapy in mid- to late-stage HD, and program perception by participants/caregivers. Methods: Six participants with manifest HD completed a six-week aquatherapy program comprised of twiceweekly sessions. Participant-tailored aquatherapy sessions involved a warm-up, exercise-set, and a cool-down. Study notes regarding injury and compliance were recorded to track measures of safety and feasibility. Participants (and caregivers where available) gave an interview following the program. Conversations were audio recorded and fully transcribed. Interviews were analyzed to extract themes. Results: Generally, participants reported the aquatherapy to be enjoyable, feasible, and safe, as well described improved mood, sleep, and quality of life. Anecdotal evidence suggests that many participants experienced improved physical conditioning. Conclusions: Twice-weekly aquatherapy is feasible in mid- to late-stage HD, and was perceived to be safe and enjoyable.