Aim: Postural and gait instability in Huntington's disease (HD) is a key component of the motor symptomatology which contributes to an increased risk of falls. Rehabilitation is considered benefi cial in postural and gait stability treatment. We aimed to explore the feasibility and the shortand long-term eff ects of an inpatient multidisciplinary rehabilitation program on postural and gait stability in subjects with HD. Methods: A sample of 13 subjects with HD but with no severe cognitive defi cit or depression underwent a 3-week specifi c inpatient rehabilitation program focused on postural and gait stability. Patients were examined at the baseline, after the completion of rehabilitation, and then 1 month and 3 months after the end of the program. The testing included: gait stability examination (Dynamic Gait Index; DGI), posturography examination of postural stability on a stable (PSS) and 20% unstable (PSU) platform and the total motor score evaluation by Unifi ed Huntington's Disease Rating Scale (UHDRS). Results: There was a signifi cant improvement lasting 3 months in PSS and a signifi cant improvement in DGI immediately after the rehabilitation. There was no signifi cant improvement in the PSU and UHDRS total motor score. Conclusion: Specifi c rehabilitation methods are safe and feasible and may be benefi cial in the treatment of postural and gait instability in patients with early and mid-stage HD. The postural instability improvement measured by PSS persisted for at least 3 months. The gait stability improvement in DGI did not persist after 1 month. We found no improvement in PSU. This exploratory study off ers a sample of a specifi c rehabilitation protocol for stability training in HD. The authors declare they have no potential confl icts of interest concerning drugs, products, or services used in the study. Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy. The Editorial Board declares that the manuscript met the ICMJE "uniform requirements" for biomedical papers. Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do biomedicínských časopisů.

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BackgroundHuntington's disease (HD) is an untreatable hereditary neurodegenerative disease manifesting various types of motor disorders including stability and gait disturbances, together with cognitive and behavioural impairments. The symptomatic therapy is limited and temporary. Rehabilitation (Rhb) is considered to be beneficial in postural and gait instability treatment and prevention of falls. However, there is very limited evidence-based information on the Rhb therapy effects and no specific Rhb management. AimsTo evaluate long-term effects of targeted rehabilitation on postural and gait stability in the early and middle stages of HD. Methods8 genetically verified HD patients in the early and middle stages, without severe cognitive deficit (Mini Mental State Examination >20) and without depression (Beck Depression Inventory 0–9) were examined at the baseline using UHDRS (Unified Huntington’s Disease Rating Scale), gait stability examination (Dynamic Gait Index-DGI), posturography (Limits of Stability; LOS-static, dynamic), Falls Efficacy Scale-FES (fall risk) and Clinical Global Impression-CGI (subjective effect of treatment evaluation) questionnaires. Then they underwent a 3-week inpatient rehabilitation program including: A. individual physiotherapy focused on gait, stability and coordination, twice a day 30 min., B. 60 min of condition training , C. 30 min of occupational therapy. The follow-up testing with the same battery was realised immediately, 1 month and 3 months after completion of the rehabilitation programme.ResultsThere was a statistically significant improvement in DGI (p < 0.001) in all intervals compared to the baseline and in LOS-static (p = 0.003) in all intervals compared to the baseline. No improvement was found in UHDRS and questionnaires (FES, CGI).ConclusionsSpecific rehabilitation methods improve the postural and gait stability in patients with HD. The effect persists at least for 3 months.With the support of: GAUK 1888214, IGA NT 11190–6/2010 and PRVOUK P26/LF1/.