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J05 Task-specific Training In Huntington’s Disease: A Randomised, Controlled Feasibility Trial
  1. L Quinn1,
  2. K Debono1,
  3. H Dawes2,
  4. A Rosser3,4,
  5. AH Nemeth5,
  6. O Quarrell6,
  7. H Rickards7,
  8. SJ Tabrizi8,
  9. I Trender-Gerhard9,
  10. M Kelson10,
  11. J Townson10,
  12. M Busse1
  13. and the members of the TRAIN-HD project group
  1. 1School of Healthcare Sciences, Cardiff University, Cardiff, UK
  2. 2Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, UK
  3. 3Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Heath Park, Cardiff, UK
  4. 4Cardiff Brain Repair Group, School of BioSciences, Cardiff University, Museum Avenue, Cardiff, UK
  5. 5Department of Clinical Genetics, Churchill Hospital, Oxford, UK
  6. 6Sheffield Children’s Hospital, Sheffield, UK
  7. 7Department of Neuropsychiatry, University of Birmingham, The Barberry, 25 Vincent Drive, Edgbaston, Birmingham, UK
  8. 8University College London,UCL Institute of Neurology, Department of Neurodegenerative Diseases, Queen Square, London, UK
  9. 9Institute of Human Development, University of Manchester, Manchester, UK
  10. 10South East Wales Trials Unit, Institute for Translation, Innovation, Methodology and Engagement (TIME), Cardiff University School of Medicine, Cardiff, UK

Abstract

Background Motor learning principles suggest that interventions to promote mobility should incorporate goal-directed activities within the specific environmental context to achieve better outcomes.

Aims We aimed to determine the feasibility, safety and potential benefit of goal-directed, task-specific mobility training for individuals with mid-stage HD.

Methods Thirty individuals were enrolled and randomised into control or intervention groups in this multi-centre trial. Training focused on walking, sit-to-stand and standing activities, twice a week for 8 weeks at home. Goal attainment scaling was used to individualise and direct the intervention. Time to complete 5 chair sit-to-stand repetitions (5CST) was recorded at each intervention session. Adherence and adverse events were monitored. Adjusted between-group comparisons on standardised outcome measures (blinded) at 8 and 16 weeks informed assessment of benefit.

Results Loss to follow up was minimal (2 participants); adherence in the intervention group was excellent (96.9%). Ninety-two percent (92%) of goals were achieved at the end of the intervention and 46% achieved much better than expected outcome; the majority of goals focused on improving walking endurance and confidence. Mean (95% CI) improvement in 5CST in intervention group was 5.5 sec (2.2, 8.9). There was no clear evidence of benefit on standardised outcome measures at 8- or 16-week assessments.

Conclusions Most participants exceeded goal expectation with excellence adherence. While the programme was well received by people with HD and facilitated achievement of personal mobility goals, training intensity and specificity was likely insufficient to achieve systematic improvements in standardised outcome measures.

KeyWords
  • physiotherapy
  • task-specific training

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