Effects of multidisciplinary therapy on physical function in Huntington's disease
Travis M. Cruickshank, Edith Cowan UniversityFollow
Alvaro P Reyes
Luis E Penailillo
Tim Pulverenti, Edith Cowan UniversityFollow
Danielle M. Bartlett, Edith Cowan UniversityFollow
Pauline Zaenker, Edith Cowan UniversityFollow
Anthony J. Blazevich, Edith Cowan UniversityFollow
Robert Newton, Edith Cowan UniversityFollow
Jennifer A Thompson, Edith Cowan University
Johnny Lo, Edith Cowan UniversityFollow
Mel R. Ziman Dr, Edith Cowan UniversityFollow
Acta neurologica Scandinavica
School of Medical and Health Sciences
OBJECTIVE: The primary objective of this trial was to evaluate the effects of outpatient multidisciplinary therapy, compared to usual care, on measures of physical function and muscle strength in patients with manifest Huntington's disease (HD).
METHODS: Twenty-two patients with clinically verified HD were randomized to receive 36 weeks of outpatient multidisciplinary therapy or usual care. Outpatient multidisciplinary therapy comprised 9 months of supervised exercise, cognitive therapy and self-directed home-based exercise. Usual care consisted of standard medical care. Patients were assessed at 0 and 36 weeks by blinded assessors. The primary outcome was changed in mobility as measured by the 10-m Timed Walk Test. Secondary outcome measures included changes in manual dexterity (Timed Nut and Bolt Test), balance (Berg Balance Scale), cardiorespiratory endurance (6-Minute Walk Test) and upper and lower extremity muscle strength (isokinetic and isometric muscle strength and 10 Repetition Sit-to-Stand Tests).
RESULTS: Patients receiving outpatient multidisciplinary therapy demonstrated significantly enhanced manual dexterity (P < 0.05) and lower extremity muscle strength (P < 0.05) than patients receiving usual care. No significant differences in mobility, balance, cardiorespiratory endurance and upper extremity strength outcomes were observed between groups after the intervention period. There were no adverse events associated with multidisciplinary therapy.
CONCLUSION: Our findings suggest that outpatient multidisciplinary therapy has positive effects on manual dexterity and muscle strength, but no meaningful effects on mobility, balance, cardiorespiratory endurance and upper extremity muscle strength in patients with HD. Larger randomized controlled trials are needed to confirm these preliminary findings.