The Journal of Huntington’s Disease recently published a review of studies evaluating the effectiveness of physical therapy or exercise interventions among people with the disease.
The authors used the Joanna Briggs Institute approach to conduct the mixed-methods systematic review of the research, which included various types of exercise interventions, including aerobic exercise, strengthening exercise, balance training, functional exercise, video game-based exercise, and assistive device training. The most common intervention was a combination of aerobic and strengthening exercises, according to an article in Neurology Advisor.
The review included studies published between 2003, when the last systematic review on the topic was published, and 2016. The final review consisted of 18 quantitative studies that included a wide range of outcome measures for physical and cognitive function, and two qualitative studies that identified patient and family perceptions of the interventions.
Most of the studies were conducted in Europe and published between 2013 and 2016. Three studies each were conducted in the United States and Australia. There was a combined total of 441 participants, the article explains.
According to the researchers, three of five studies, which used either the United Huntington’s Disease Rating Scale-Total Motor Score (UHDRS-TMS) or the modi?ed Motor Score (mMS), demonstrated statistically significant improvements in motor scores.
In addition, four of seven studies investigated the effect of exercise or physical therapy on gait speed using either the 10-meter walk test or the 5-meter GAITRite instrumental mat. Statistically significant improvements were observed in four of the studies, one of which was a randomized controlled trial and three of which had a pre/post design.
Of seven studies that examined balance as a secondary outcome, one showed greater improvement on the Romberg test in the intervention group versus controls, the news story continues. In several other studies, patients maintained or improved on Berg Balance Scale scores following intervention.
Of four studies that examined balance confidence as a secondary outcome, one found improvements on the Activities Balance Confidence scale for both walking and stairs in the intervention group, while scores in the control group declined.
A limited number of studies reported improvements in muscle strength, maximum oxygen consumption per unit time (VO2 max), body composition, pulmonary function, and depression. Results regarding improvements in quality of life were mixed. Most studies that examined cognitive function showed no significant differences between intervention and control groups.
Results of the qualitative studies indicate that patients with HD and their caregivers view exercise as beneficial, with noted improvements in physical and social domains. Also described were barriers to exercise participation, including lack of motivation and cognitive and physical impairment, and facilitators such as caregiver support and individualized and group training, the story continues.
“Exercise and physical therapy are important interventions that should be considered as primary intervention strategies in all patients with HD,” states review co-author Lori Quinn, EdD, PT, associate professor of movement science and kinesiology, and director of the Neurorehabilitation Research Lab at Teachers College of Columbia University, in the news story.
“These interventions have the potential to not only improve daily activity performance, function, and quality of life, but also to meaningfully impact disease progression.”
[Source: Neurology Advisor]
