Effects of multidisciplinary therapy on physical function in Huntington's disease

Cruickshank, Travis; Reyes, Álvaro; Peñailillo, Luis; Pulverenti, Timothy S.; Bartlett, Danielle; Zaenker, Pauline; Blazevich, Anthony J.; Newton, Robert U.; Thompson, Jennifer A.; Lo, Johnny; Ziman, Mel

doi:10.1111/ane.13002

Cited by 21 publications

(28 citation statements)

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“…The initial search yielded 2,377 records that ultimately resulted in 18 quantitative articles and 2 qualitative included articles [11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] ; a flowchart is available in our published systematic review. 5 The updated search included 5 additional quantitative articles [31][32][33][34][35] and 1 additional qualitative article, 36 resulting in a total of 23 quantitative and 3 qualitative studies reviewed. A table summarizing all quantitative studies is publicly available on aan.…”

Section: Literature Searchmentioning

confidence: 99%

“…Interventions to improve mobility included gait and transfer training, 26 stationary cycling with a home walking program and resistance exercise, 12 use of a dance-based video game, 21 home exercise with a DVD and a walking program, 19 a gymbased exercise program including aerobic and resistance exercise, 27 and an outpatient-based multidisciplinary intervention of supervised aerobic and resistance training. 35 Gait speed (measured with the 10-meter walk test [10MWT]) improved after use of a DVD for home exercise and a walking program delivered 3 times a week over 8 weeks 19 and following 36 weeks of gait and resistance training. 35 Gait speed did not improve in the home-based, task-specific exercise program, but all participant-directed gait-related goals were met.…”

Section: Supporting Evidence and Clinical Interpretationmentioning

confidence: 99%

“…35 Gait speed (measured with the 10-meter walk test [10MWT]) improved after use of a DVD for home exercise and a walking program delivered 3 times a week over 8 weeks 19 and following 36 weeks of gait and resistance training. 35 Gait speed did not improve in the home-based, task-specific exercise program, but all participant-directed gait-related goals were met. 26 The gym-based aerobic and resistance training program, a feasibility study, and dance-based video game play, which did not incorporate walking training, did not improve gait speed.…”

Section: Supporting Evidence and Clinical Interpretationmentioning

confidence: 99%

“…Of the 102 survey respondents, 45 endorsed working with individuals with late-stage HD. Of those, 82.2% endorsed the use of positioning, 71.1% used ROM exercise, 73.3% used active movement, 48.9% included respiratory exercises, 88.9% incorporated education to support patients, medical staff, and caregivers,35.6% reported using additional interventions for late-stage care, and only 2.2% of respondents (i.e., 1 respondent) did not use any of these strategies.…”

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confidence: 99%

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Clinical recommendations to guide physical therapy practice for Huntington disease

et al. 2020

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ObjectiveIn the past decade, an increasing number of studies have examined the efficacy of physical therapy interventions in people with Huntington disease (HD). MethodsWe performed a mixed-methods systematic review using Joanna Briggs Institute (JBI) methodology and included experimental and observational study designs. The search resulted in 23 quantitative studies and 3 qualitative studies from which we extracted data using JBI standardized extraction tools. Results of this review suggested that physical therapy interventions may improve motor impairments and activity limitations in people with HD. Here, we expand on the review findings to provide specific recommendations to guide clinical practice. ResultsWe recommend the following specific physical therapy interventions for people with HD: aerobic exercise (grade A evidence), alone or in combination with resistance training to improve fitness and motor function, and supervised gait training (grade A evidence) to improve spatiotemporal features of gait. In addition, there is weak (grade B) evidence that exercise training improves balance but does not show a reduction in the frequency of falls; inspiratory and expiratory training improves breathing function and capacity; and training of transfers, getting up from the floor, and providing strategies to caregivers for involvement in physical activity in the midstages of HD may improve performance. There is expert consensus for the use of positioning devices, seating adaptations, and caregiver training in late stages of HD. ConclusionsThere is strong evidence to support physical therapy interventions to improve fitness, motor function, and gait in persons with HD.This clinical practice guideline provides clinical recommendations for physical therapy interventions and patientreported outcomes for individuals with Huntington disease (HD). The target audience are rehabilitation professionals and referring physicians providing care to persons with HD. The recommendations should be interpreted by the clinician in the context of their specific clinical practice and the patient's impairments, goals, and disease stage, while considering the potential for harm.We used the Joanna Briggs Institute (JBI) method for critical appraisal of research, assignment of evidence to the literature, and assignment of levels of strength to the recommendation. The JBI method allows for inclusion of experimental study designs other than randomized controlled trial, such as observational study designs, retrospective and prospective cohort studies, expert consensus, and qualitative studies. The inclusion of a wide range of study designs (i.e., all levels of evidence) was critical, given the paucity of randomized controlled trials involving physical therapy in HD. The guideline is organized according to the level of evidence and the grade of the recommendation (tables 1 and 2) underpinning action statements. A summary of action statements, a description of each action statement, and research recommendations are provided.Each individual articl...

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Section: Literature Searchmentioning

confidence: 99%

Section: Supporting Evidence and Clinical Interpretationmentioning

confidence: 99%

Section: Supporting Evidence and Clinical Interpretationmentioning

confidence: 99%

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confidence: 99%

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Clinical recommendations to guide physical therapy practice for Huntington disease

et al. 2020

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“…Aspectos socioeconômicos dos sujeitos com doença de Huntington atendidos em um ambulatório de Fisioterapia do Distrito Federal, 2018.DISCUSSÃOSobre a força muscular, a amostra apresenta escores inferiores ao referencial de normalidade, o que pode levar à diminuição na mobilidade e estabilidade e justificar as dependências para as ABVD e risco de quedas25 . No estudo de Cruickshank et al, foi proposto um protocolo multiprofissional cujo objetivo era melhorar mobilidade, força muscular e humor em 22 sujeitos com DH e, após 36 semanas de acompanhamento, observaram efeitos positivos que foram gerados por meio desse protocolo, que incluía o treino de força muscular como parte do tratamento26 .…”

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Perfil e capacidade funcional em sujeitos com Doença de Huntington

et al. 2020

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Objetivo: traçar o perfil e a capacidade funcional de sujeitos com Doença de Huntington (DH) atendidos em um ambulatório de fisioterapia do Distrito Federal. Método: trata-se de um estudo transversal em que foram aplicados um questionário para coletar informações gerais para traçar o perfil, além do índice de Barthel, escala Lawton para medir grau de independência para as atividades de vida diária, força de preensão palmar por meio do dinamômetro JAMAR®, equilíbrio por meio da escala de equilíbrio de Berg, declínio cognitivo por meio da Montreal Cognitive Assessment (MoCA), e risco de disfagia utilizando a Eating assessment tool (EAT-10). Resultados: foram avaliados sete sujeitos, 58% homens e 42% mulheres com média de idade de 45,8±10,5 anos e tempo médio de diagnóstico de 7,5±4,2 anos. Todos apresentam redução da força de preensão palmar (21,1±7,3 Kg/F) e declínio cognitivo (13,1±4,2 pontos) no MoCA. Sobre o risco de cair, este se fez presente em todos os participantes com o risco de disfagia. Conclusão: os indivíduos com Doença de Huntington apresentaram déficit cognitivo, diminuição da força de preensão palmar e alterações de marcha; porém, ainda mantêm independência para as atividades básicas de vida diária , além de risco para a disfagia.

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