Exploring relationships among gait, balance, and physical activity in individuals with Huntington's disease

Abstract

Background Individuals with Huntington's disease (HD) experience a variety of motor and non-motor symptoms, but little is known about how these symptoms are related to one another. It is important to characterize the deficits present and explore the relationships among these symptoms in order to provide high quality clinical care. Objective The purpose of this study was to characterize gait, balance, and physical activity level in individuals with HD and explore the relationships among motor and non-motor symptoms. Methods Individuals completed one lab visit and wore a sensor for seven days to capture physical activity level. During the lab visit, gait, balance, and cognitive status were assessed using validated measures. A 2 × 2 ANOVA (Group×Condition) was used to assess differences in gait between individuals with HD vs. controls, while t-tests were used for other clinical measures. Correlations as well as a mixed effects model explored relationships among clinical measures in the HD group. Results Individuals with HD walk significantly slower and have significantly worse balance than controls. Gait velocity and balance were significantly correlated with cognitive status in individuals with HD. Additionally, balance performance and balance confidence were not significantly correlated, indicating that there may be a lack of self-awareness of deficits present in individuals with HD. In-lab measures were not significant predictors of physical activity. Conclusions Motor impairments in individuals with HD are correlated with cognitive impairment. Clinicians should be aware of the impact of cognitive impairment when selecting interventions to address motor symptoms in individuals with HD.