Home-Based Exercise to Improve Motor Functions, Cognitive Functions, and Quality of Life in People with Huntington’s Disease: A Systematic Review and Meta-Analysis

Abstract

Exercise in different settings has become a fundamental part of Huntington’s disease (HD) management. The aim of this systematic review and meta-analysis was to investigate the effectiveness of home-based exercises (HBE) in HD. Randomized controlled trials (RCTs) investigating the effect of HBE on motor, cognitive, or health-related quality of life (QoL) outcomes in HD were included. Standardized mean difference (SMD), the 95% confidence interval, and p-values were calculated by comparing the outcomes change between HBE and control groups. Seven RCTs met the inclusion criteria. The included RCTs prescribed different types of HBEs, i.e., aerobic strengthening, walking, balance, and fine motor exercises. The HBE protocol length was between 6 and 36 weeks. The meta-analyses showed a significant effect of HBE intervention on motor function measure by Unified Huntington Disease Rating and overall QoL measure by Short Form−36 post-treatment respectively, [SMD = 0.481, p = 0.048], [SMD = 0.378, p = 0.003]. The pooled analysis did not detect significant changes in cognition, gait characteristics, or functional balance scales. The current study shows the positive effect of HBE in HD, especially on motor function and QoL. No significant adverse events were reported. The current results support the clinical effect of HBE intervention on motor function and QoL in HD patients. However, these results should be taken with caution due to the limited available evidence. Well-designed clinical studies that consider the disease severity and stages are required in the future.

The effectiveness of home-based therapeutic exercises on adults with fibromyalgia: a systematic review and meta-analysis

“…The HBE includes a set of stretching, strengthening, and endurance exercises. These exercises can reduce muscle imbalance, improve joint flexibility, correct dynamic and static postural control processes, and enhance movement and gait endurance [10,24]. Furthermore, exercises reduce pain sensitization and increase pain threshold [45].…”

“…Home-based exercises (HBE) can help to engage exercises in patients' lives, which are unsupervised or may combine with limited supervision. Several studies reported a positive impact of HBE on improving physical function, pain, balance, and QOL in different conditions including knee osteoarthritis, post-total knee arthroplasty, and Parkinson's disease [21][22][23][24]. In contrast, there are conflicting results between studies that assessed the effect of HBE on fibromyalgia patients [25][26][27].…”

Efectividad del ejercicio terapéutico en la “Unified Huntington´s Disease Rating Scale” en pacientes diagnosticados de Enfermedad de Huntington (Effectiveness of therapeutic exercise on the “Unified Huntington´s Disease Rating Scale” in patients diagnosed with Huntington´s Disease)

“…La literatura actual afirma que una intervención de ejercicio terapéutico de corta duración, produce mejoras en la forma física, la función motora y la calidad de vida de los/las pacientes con EH (Kim et al, 2021). Siguiendo esta línea, la revisión sistemática de Al-Wardat et al, (2022) concluye que el ejercicio físico supervisado presenta efectos positivos tanto a nivel físico como social, mientras queFritz et al, (2017) afirman que los ejercicios domiciliarios (de fuerza, aérobicos, equilibrio y motricidad fina) presentan efectos significativos sobre la calidad de vida y la función motora, aunque sobre la cognición, el equilibrio funcional y la marcha no se encontraron diferencias significativas. Además, Trembath et al, (2010), afirman que un estilo de vida sedentario puede desencadenar los síntomas de la enfermedad, y que la actividad física podría retrasar su evolución.…”