Background As the disease progresses, people with Huntington's disease (HD) have a decreased awareness of their body and develop their own movement patterns. Therefore, specialised physiotherapy input is essential at each stage in the management of HD. The therapeutic options and results are influenced not only by the extent of the disturbance of motor control but also by cognitive, behavioural, and motivational disturbances of the participants and their belief in a beneficial intervention. It is well known that motivation and behaviour are common limiting factors for the therapy in HD. Therefore, there is a need for strategies to encourage individuals to adhere to physiotherapeutic interventions. However, depending on our experiences, active exercises with turning, crawling, etc are often little motivating and disappointing for patients and may lead to frustration very early in the course of the therapy.

Aim To ease the access to patients for developing a more positive self-perception and to increase their motivation to participate in the therapy.

Methods The intervention consists of three phases. Phase I: passive exercises performed by the therapist for the patient to perceive the movement itself; Phase II: active imagination of the movements by the patient; Phase III: conduction of active exercises assisted by the therapist; followed by active physiotherapeutic exercises according to the patient's wishes.

Results The motivation of the patients, their satisfaction and therapy compliance has increased considerably in our clinic. In addition, positive effects of this intervention have also been noticed in improved voluntary movements.

Conclusion We recommend the described intervention as an alterative type of physiotherapeutic practice that can be combined easily with the traditional therapies in HD independent of the disease stage. This intervention also has the advantage that it can be applied independent of the locality, even when there is only limited space.