Physical therapy in Huntington's disease – preliminary results of an ongoing study

Background: Huntington's Disease (HD) is a neurodegenerative disorder that leads to motor deficits as well as cognitive and psychiatric symptoms. Motor deficits, e.g. chorea, account for a higher risk of falls among HD patients. Zinzi et al. showed that an intensive inpatient training with physical therapy and other types of training can improve functional and motor performance in this patient group (Zinzi et al., 2007).

Objective: To investigate whether a regular outpatient physical therapy training improves postural stability.

Patients and methods: 11 HD patients in early to middle stages of disease received one-hour personal physical therapy training aiming at the improvement of stance and balance twice a week for 6 weeks. Patients were assessed 6 weeks before the training period, before and after the training period. Another assessment is planned 6 weeks after the end of therapy (outstanding). For balance assessment, patients were instructed to stand still on a force Plate for 25s. During this time, the center of mass projected to the surface was recorded and the area of projection was calculated. Statistical analysis was performed using the Wilcoxon Test.

Results: So far, the differences in the projection area size were not significant between any two assessment timepoints (p>0,05 in all cases). However, the group median was 1463,9cm² before and 796,1cm² after the training period (p=0,155)

Discussion: To justify physical therapy as a regular part of HD treatment, evidence for the effectiveness of regular outpatient physical therapy training is desireable. In this ongoing study, we did not yet find significant effects, however, based on our preliminary observations, we hypothesize that results may reach statistical significance after reaching the recruitment target of 20 subjects.