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Clinical therapeutics
Q20 A multidisciplinary intensive rehabilitation programme for persons with Huntington's disease: results after 1 year
  1. A Piira1,
  2. M van Walsem2,
  3. G Mikalsen1,
  4. KH Nilsen3,
  5. SF Knutsen1,
  6. J Frich4,5
  1. 1North Norway Rehabilitation Center, Tromsø, Norway
  2. 2Department of Neurorehabilitation, Oslo University Hospital, Oslo, Norway
  3. 3Vikersund Rehabilitation Center, Vikersund, Norway
  4. 4Department of Neurology, Oslo University Hospital, Oslo, Norway
  5. 5Institute of Health and Society, University of Oslo, Oslo, Norway

Abstract

Background Persons with Huntington's disease (HD) may benefit from intensive rehabilitation.

Aim To assess effects of an intensive, multidisciplinary rehabilitation programme in subjects with early to mid-stage HD.

Methods 37 subjects completed a 1-year rehabilitation programme at two in-patient rehabilitation centres. The programme consisted of three stays, three weeks each, and a 5-day evaluation stay. Focus was on daily physical exercise, social activities and teaching sessions. Baseline characteristics: Mean age: 52.4 years; 51.4% women; mean TFC: 8.9; mean UHDRS motor score: 35.6; mean MMSE score: 25.4.

Results Effects were observed in gait function, from baseline to the evaluation stay: 6 Minute Walk Test (6MWT): +71 m, p<0.01; 10 Meter Walk Test (10MWT):–0.9 s, p<0.01; Timed Up and Go (TUG) test:–1.5 s, p<0.01. A significant proportion of subjects improved or had unchanged walking function respectively; 6MWT 80.7% (25/31) (p=0.001), TUG 80.7% (25/31) (p=0.001) and 10MWT 87.1% (27/31) (p=0.001). Improvement in balance function was observed: Berg balance scale (BBS): +1.1 points, p<0.05; Mean Activity Specific Balance Confidence Scale: +2.3, p=ns. There was no significant improvement in cognitive function as measured by mean change in MMSE score: +0.67 (p<ns). SF-12 showed improvement in physical health: +5.7, p<0.01. ADL function did not change (Barthel index:) +0.1, p=ns, although 84.4% (27/32, p<0.001) of the subjects improved or had a stable score. Mean HADS score was reduced: −3.8 (p<0.01) and 78.1% (25/32, p<0.001) reported a statistically sign. reduction or stayed stable on anxiety and depression. Mean change in BMI was +0.7 (p<0.05).

Conclusions A multidisciplinary intensive rehabilitation programme in persons with early and middle stage HD is associated with improved balance, gait function, physical quality of life and with reduced depression and anxiety. Longer follow up is needed to assess if these positive effects are sustained.

  • Huntington's disease
  • rehabilitation

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