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Clinical recommendations to guide physical therapy practice for Huntington disease

Quinn, Lori ORCID:, Kegelmeyer, Deb, Kloos, Anne, Rao, Ashwini K., Busse-Morris, Monica ORCID: and Fritza, Nora E. 2020. Clinical recommendations to guide physical therapy practice for Huntington disease. Neurology 94 (5) , pp. 217-228. 10.1212/WNL.0000000000008887
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Objective In the past decade, an increasing number of studies have examined the efficacy of physical therapy interventions in people with Huntington disease (HD). Methods We performed a mixed-methods systematic review using Joanna Briggs Institute (JBI) methodology and included experimental and observational study designs. The search resulted in 23 quantitative studies and 3 qualitative studies from which we extracted data using JBI standardized extraction tools. Results of this review suggested that physical therapy interventions may improve motor impairments and activity limitations in people with HD. Here, we expand on the review findings to provide specific recommendations to guide clinical practice. Results We recommend the following specific physical therapy interventions for people with HD: aerobic exercise (grade A evidence), alone or in combination with resistance training to improve fitness and motor function, and supervised gait training (grade A evidence) to improve spatiotemporal features of gait. In addition, there is weak (grade B) evidence that exercise training improves balance but does not show a reduction in the frequency of falls; inspiratory and expiratory training improves breathing function and capacity; and training of transfers, getting up from the floor, and providing strategies to caregivers for involvement in physical activity in the midstages of HD may improve performance. There is expert consensus for the use of positioning devices, seating adaptations, and caregiver training in late stages of HD. Conclusions There is strong evidence to support physical therapy interventions to improve fitness, motor function, and gait in persons with HD.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Centre for Trials Research (CNTRR)
Publisher: American Academy of Neurology (AAN)
ISSN: 0028-3878
Date of First Compliant Deposit: 12 November 2019
Date of Acceptance: 8 November 2019
Last Modified: 04 May 2023 22:12

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