Background Individuals with HD develop postural instability and gait deviations with concurrent loss of function. While trunk sway is a prominent symptom of HD, little is known about its impact on functional task performance.
Aims We explored the relationship among trunk sway during static and dynamic tasks and measures of gait, mobility, and falls.
Methods Forty individuals with HD (mean age = 52.05 ± 10.09, Total Functional Capacity score = 7.32 ± 3.48) participated. Trunk (thoracic and pelvic) angular excursions in sitting, standing and walking (measured with smartphone application), gait (GAITRite), mobility (Tinetti mobility test (TMT)) and falls in past week were assessed.
Results Multiple stepwise linear regression analysis showed that total pelvic anterior-posterior (AP) excursion in sitting explained 41.5% of the variance of UHDRS motor scores (p < 0.0001). Greater than 48% (R2 = 0.484) of the variance in TMT was explained by total pelvic AP excursion in walking (p < 0.0001) and total thoracic medial-lateral (ML) excursion in standing (p < 0.0001), while greater than 26% (R2 = 0.262) of the variance in velocity was explained by peak thoracic excursion in the anterior direction in walking (p = 0.015) and total pelvic AP excursion in standing (p = 0.009). Thirty-one percent (R2 = 0.310) of the variance in double support percent, the portion of the gait cycle related to balance, was explained by total pelvic excursion ML in standing (p = 0.009) and peak thoracic excursion in the posterior direction in walking (p = 0.006). Interestingly, age was negatively correlated with reported falls, with falls being associated with younger age (r = −0.44, p = 0.004) and increased posterior pelvic tilt in standing (r = 0.54, p = 0.033).
Conclusions Trunk sway measures help explain impairments in gait, mobility and falls in individuals with HD, and may represent a novel rehabilitation intervention in HD.
- trunk control
- trunk sway