Exercise in Huntington’s Disease: Current State and Clinical
                        Significance

Mueller, S.; Petersen, Jens A.; Jung, Hans H.

doi:10.5334/tohm.515

Cited by 31 publications

(29 citation statements)

References 47 publications

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“…Adequately powered large RCTs are difficult to achieve in rare conditions; therefore, alternatives are being sought. Although randomized trials are the gold standard for obtaining unbiased treatment effect estimates, cohort nonrandomized interventional studies may be able to provide treatment effects that can be adjusted to account for the lack of randomization.…”

Section: Discussionmentioning

confidence: 99%

Exercise Interventions in Huntington's Disease: An Individual Patient Data Meta‐Analysis

Playle

Dimitropoulou

Kelson

et al. 2019

Movement Disord Clin Pract

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Background Physical activity may be beneficial in Huntington's disease (HD); however, studies to date have been underpowered to detect change. We combined data from five randomized controlled feasibility trials using individual patient data meta‐analyses. Methods/Design All trial interventions comprised a combination of supervised and self‐directed physical activity, with varied emphasis on aerobic, strength, endurance, flexibility, and task training. Duration ranged from 8 to 16 weeks. The primary outcome was the modified Unified Huntington's Disease Rating Motor Score. Secondary outcomes included the Symbol Digit Modality Test, Berg Balance Scale, 30‐second Chair stand, Timed Up and Go, Gait Speed, Physical Performance Test, Six‐Minute Walk, International Physical Activity Questionnaire, Hospital Anxiety and Depression Scale, EuroQol Health Utility Index, and Short‐Form 36 Health Related Quality of Life Scale. The primary analysis utilized a two‐stage approach. A one‐stage approach was explored as a sensitivity analysis using a cross‐classified (by study site) linear mixed‐effects model. Results One hundred twenty‐one participants provided complete data. Risk of bias was moderate; however, primary outcomes were blind assessed. Primary pooled effect estimates adjusted for baseline modified motor score (95% confidence interval) were 0.2 (–2.1 to 2.6) favoring control. There was considerable heterogeneity between the studies. Conclusions There was no evidence of an exercise effect on the modified motor score in these relatively short‐duration interventions. Longer‐duration trials incorporating supervised components meeting frequency, intensity, time, and type principles are required. Lack of common outcomes limited the analysis and highlight the importance of a core outcome set for evaluating exercise in HD.

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Section: Discussionmentioning

confidence: 99%

Exercise Interventions in Huntington's Disease: An Individual Patient Data Meta‐Analysis

Playle

Dimitropoulou

Kelson

et al. 2019

Movement Disord Clin Pract

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“…Physical therapy and exercise interventions were integrated into the treatment decades ago, in order to maintain patient’s independence in daily life activities, while attenuating the damages in the motor function. It is indeed known that a passive lifestyle might lead to an earlier HD onset; while, as in other neurodegenerative diseases, exercise exerts a positive effect [242,243]. Recent studies have focused on both resistance and endurance exercise training modalities, based on the suggestion that both could be of help in HD patients.…”

Section: A Few Examples Of Exercise Effects On Neurodegeneration: mentioning

confidence: 99%

“…Recent studies have focused on both resistance and endurance exercise training modalities, based on the suggestion that both could be of help in HD patients. All the results showed a significant increase in grey matter volume and significant improvements in verbal learning and memory, after long-training exercise [243,244,245,246,247,248].…”

Section: A Few Examples Of Exercise Effects On Neurodegeneration: mentioning

confidence: 99%

Physical Activity and Brain Health

Liegro

Schiera

Proia

et al. 2019

Genes

244

164

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Physical activity (PA) has been central in the life of our species for most of its history, and thus shaped our physiology during evolution. However, only recently the health consequences of a sedentary lifestyle, and of highly energetic diets, are becoming clear. It has been also acknowledged that lifestyle and diet can induce epigenetic modifications which modify chromatin structure and gene expression, thus causing even heritable metabolic outcomes. Many studies have shown that PA can reverse at least some of the unwanted effects of sedentary lifestyle, and can also contribute in delaying brain aging and degenerative pathologies such as Alzheimer’s Disease, diabetes, and multiple sclerosis. Most importantly, PA improves cognitive processes and memory, has analgesic and antidepressant effects, and even induces a sense of wellbeing, giving strength to the ancient principle of “mens sana in corpore sano” (i.e., a sound mind in a sound body). In this review we will discuss the potential mechanisms underlying the effects of PA on brain health, focusing on hormones, neurotrophins, and neurotransmitters, the release of which is modulated by PA, as well as on the intra- and extra-cellular pathways that regulate the expression of some of the genes involved.

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“…These methods may reduce or stabilize disease progression in other progressive neurodegenerative disorders, such as Parkinson's disease (PD) [7]. Recent studies have investigated the use of physical therapy for HD patients [28][29][30][31][32]. Multidisciplinary rehabilitation programs are safe and feasible interventions that positively affect verbal learning and memory, anxiety and depression, quality of life, balance, spatial-temporal gait parameters, and gray matter changes [33][34][35][36].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Use of Music, Dance, and Rhythmic Auditory Cueing for Patients with Huntington’s Disease: A Systematic Review

Schwartz

Walsem

Brean

et al. 2019

JHD

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Background: Studies have assessed the therapeutic effect of music, dance, and rhythmic auditory cueing for patients with Huntington's disease (HD). However, the synthesis of evidence in support of their positive impact on symptoms is lacking. Objective: We conducted a systematic literature review to evaluate the potential benefits of music, dance, and rhythm on the cognitive, psychiatric and motor function in patients with HD. Methods: Two-and three-keyword searches and a manual search identified medical literature published from 1999 through 2019. We considered literature that assessed outcomes of art-based rehabilitation programs or individual modalities for persons with early, middle, or advanced HD. Structured analysis was conducted using data entry tables with categories for patient health status, art methods, and outcomes. Results: Seven articles and six abstracts met eligibility criteria, of which nine evaluated art-based rehabilitation programs. Studies mainly assessed cognitive, psychiatric, and motor functions through music, dance, or rhythm modalities. Although results were conflicting, in summary improvements to motor function were dependent on disease severity and more responsive to art therapy programs than rhythm-motor synchronization. Benefits to global cognition that resulted from rhythmic training correlated with microstructural changes. Qualitative data verified a positive impact on language production, chorea, behavior, and quality of life. Conclusion: Our review has shown a potential benefit of music, dance, and rhythm for patients with HD, which is particularly important for a disease that has no cure. Art forms seemed to affect cognitive, psychiatric, motor, psychosocial, and neuroanatomical domains. However, evidence is preliminary, warranting further investigation to establish the foundation for this field.

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Exercise in Huntington’s Disease: Current State and Clinical Significance

Cited by 31 publications

References 47 publications

Exercise Interventions in Huntington's Disease: An Individual Patient Data Meta‐Analysis

Exercise Interventions in Huntington's Disease: An Individual Patient Data Meta‐Analysis

Physical Activity and Brain Health

Therapeutic Use of Music, Dance, and Rhythmic Auditory Cueing for Patients with Huntington’s Disease: A Systematic Review

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