Tolerability and psychological effects of a multimodal day-care rehabilitation program for persons with Huntington's disease

Abstract

Objective To determine whether the psychological benefits of intense, inpatient, multimodal rehabilitation for persons with Huntington’s disease (HD), as found in earlier studies, also apply in a shorter, day-care setting. Design Prospective, non-randomized cohort study. Subjects Twenty patients attending a group-based 8-week (3 days/week) rehabilitation programme aimed at persons in early stages of HD. Methods An explorative cohort study on register data from a specialized rehabilitation centre, including descriptive data, number of cancellations, a self-reported evaluation, and measures of psychiatric symptoms, health-related quality of life, sense of coherence and physical function at baseline and at the end of rehabilitation. Results Patients’ attendance rate was almost 90%. Patients were satisfied, and displayed significantly reduced anxiety and depression and improved health-related quality of life after rehabilitation. Baseline measures of sense of coherence showed significant negative correlation with the number of cancelled days of rehabilitation. Physical function improved, but did not correlate significantly with psychological outcome measures. Conclusion These results indicate that an 8-week multimodal day-care rehabilitation programme can be tolerable, reduce psychiatric symptoms, and improve health-related quality of life for people with HD. A higher sense of coherence seems to promote attendance rates. Further larger studies, including the impact of cognition and disease progression on the treatment effect, are warranted. LAY ABSTRACT Huntington’s disease (HD) is characterized by a triad of clinical features; motor, cognitive, and psychiatric. Physical training seems to have positive effects on motor symptoms. Earlier studies have shown that intense, inpatient, multimodal rehabilitation may also reduce psychiatric symptoms. The present study aimed to explore whether the psychological benefits are retained in a shorter, day-care setting.This study included 20 patients attending a group-based rehabilitation programme. The results show that participants had an almost 90 % attendance rate and were satisfied with the programme. After rehabilitation, they displayed significantly reduced anxiety and depression and improved quality of life. Sense of coherence showed a significant negative correlation with the number of cancelled days of rehabilitation. These results indicate that a shorter multimodal day-care rehabilitation programme can be easier to tolerate than longer programmes, and still reduce psychiatric symptoms and improve quality of life for people with HD. A higher sense of coherence appears to promote the attendance rate.

Quality of life, health-related quality of life, and associated factors in Huntington’s disease: a systematic review

“…Five intervention studies were performed that included (HR)QoL as a primary or main outcome measure [ 18 , 27 , 28 , 46 , 47 ]. Three out of five studies reported a beneficial intervention effect on (HR)QoL [ 27 , 46 , 47 ].…”

“…A significant and positive effect on HRQoL was also found for a multimodal rehabilitation program in 20 mHDGECs [ 47 ]. The program consisted of 25 days of rehabilitation spread across 8 weeks, and included information and education sessions, counseling, and physical training in a group setting.…”

“…However, only five intervention studies have been conducted with (HR)QoL as a primary outcome measure. Three of these studies reported beneficial effects for (HR)QoL of a multidisciplinary rehabilitation program [ 27 , 47 ] and a respiratory muscle training [ 46 ] in mHDGECs. The multidisciplinary rehabilitation programs that were carried out in two of these studies targeted some of the dynamic factors mentioned above, including physical and cognitive functioning [ 27 , 47 ], psychological functioning [ 47 ], and guidance on social support [ 47 ].…”

Quantitative CT of the knee in the IMI-APPROACH osteoarthritis cohort: Association of bone mineral density with radiographic disease severity, meniscal coverage and meniscal extrusion

“…However, only five intervention studies have been conducted with (HR)QoL as a primary outcome measure. Three of these studies reported beneficial effects for (HR) QoL of a multidisciplinary rehabilitation program [27,47] and a respiratory muscle training [46] in mHDGECs. The multidisciplinary rehabilitation programs that were carried out in two of these studies targeted some of the dynamic factors mentioned above, including physical and cognitive functioning [27,47], psychological functioning [47], and guidance on social support [47].…”

“…Five intervention studies were performed that included (HR) QoL as a primary or main outcome measure [18,27,28,46,47]. Three out of five studies reported a beneficial intervention effect on (HR)QoL [27,46,47].…”