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Clinical care and management
J02 Physical therapy for patients with Huntington's disease: effects of a treatment program and intercorrelation between outcome measures
  1. C Ekwall1,
  2. S Bohlen2,
  3. R Reilmann2,
  4. L Wiklund3
  1. 1University Hospital of Uppsala, Department of Physiotherapy, Neurosciences, Uppsala, Sweden
  2. 2University of Münster, Münster, Germany
  3. 3The Hospital of Eskilstuna, Mälarsjukhuset, Eskilstuna, Sweden

Abstract

Objective To evaluate the effect of a physiotherapeutic exercise program for patients with HD concerning motor function and disability, balance and fall related self-efficacy, and to investigate the correlation between the seven assessment tools used in the study.

Design Pre-post interventional study with baseline assessments and a quasi experimental within-group design.

Setting Out-patient clinic at a university hospital.

Participants Twelve persons with genetically confirmed Huntington's disease at an early or middle stage of the disease and with a mean age of 52, 7 SD (16, 4).

Methods The intervention comprised physiotherapy aimed to improve motor function, disability, balance, and fall-related self-efficacy, and there was a treatment focus on improvement of transitions, walking, balance, posture, postural control and fall-related self efficacy. Baseline assessments including five clinical tests and two questionnaires were made 6 weeks and 0 weeks prior to the intervention. The same tests were used 0 and 6 weeks after the intervention.

Outcome measures Over all motor function and disability measured with the Unified Huntington's Disease Rating Scale; Total Motor Score and Total Functional Assessment, static and dynamic balance measured with the One-leg stance-test, the Timed Up and GO Test, the Figure of eight-test and the Berg Balance Scale and fall-related self-efficacy measured with the Falls Efficacy Scale.

Results The physiotherapeutic exercise program demonstrated a significant improvement in balance measured with Berg balance scale (p=0.045) and indicated some positive effects on the participant's motor function (p=0.076) and fall-related self efficacy (P=0.089). The significant correlation coefficients between the different measurements of motor function, disability, balance and fall related self-efficacy range from 0.68 to 0.87.

Conclusions Physical therapy focused on transitions, walking, balance, posture, postural control and fall-related self efficacy twice a week for 6 weeks at an out-patient setting had a positive effect on the participants’ motor performance. Berg's balance scale appeared to be a useful instrument for patients with HD.

  • Huntington's disease
  • physical therapy
  • motor function
  • disability
  • balance
  • fall- related self efficacy

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