Physical Therapy and Huntington's Disease treatment and management
Effectiveness of Physical Therapy
One study tracked 40 patients with HD over two years as they followed a comprehensive rehabilitation program. The regime included both the physical and cognitive aspects from physiotherapy, occupational therapy, and speech therapy. The findings showed that over time, physical therapy had positive effects on motor and functional performance. Moreover, cognitive abilities did not decline as would be otherwise expected. These results indicate that patients are able to, at the very least, maintain a constant level of functional, motor, and cognitive performance over two years with the help of physical therapy This is important because HD is characterized by a deterioration of these abilities. However, the problem with this type of study is the lack of control groups, and difficulty in quantifying progress in the absence of any common standards.
Despite the evidence indicating that physical therapy can help people with HD maintain independence and functional capacity, recent research suggests that it is not always routinely provided. One survey revealed that only 24% of patients with HD had worked with an occupational therapist, only 8% had been seen by a physiotherapist, and close to none had been contacted by a speech therapist. Although it is unknown why physical rehabilitation services are so rarely used by patients, several explanations have been proposed. One reason may be the fact that there are very few studies that quantify the effectiveness of such treatments. Another possible reason for the limited use of rehabilitation services is reluctance in the community of service providers to accept people who are afflicted with a progressive condition, because it is thought that their chances of improvement are exceedingly low.
If more rigorous studies are completed that definitely demonstrate the effectiveness of physical therapies in slowing disease progression and improving patient quality of life, perhaps these types of treatments will be recommended to HD patients in the future.
- A. Pipathsouk, 4/12/2009
Further reading:
Bilney, B., M. Morris, and A. Perry (2003). "Effectiveness of Physiotherapy, Occupational Therapy, and Speech Pathology for People with Huntington's Disease: A Systematic Review." Neurorehabilitation and Neural Repair 17:12-24. Less technical review which outlines many of the current treatments. Provided inspiration for the table in the "Types of Physical Therapy" section.
Busse, M.E, and A.E. Rosser (2007). "Can directed activity improve mobility in Huntington's disease?" Brain Research Bulletin 72:172-174. Short, less technical review which summarizes some of the research that has been done in the field so far.
Zinzi, P., D. Salmaso, R. De Grandis, G. Graziani, S. Maceroni, A. Bentivoglio, P. Zappata, M. Frontali, and G. Jacopini (2007). "Effects of an intensive rehabilitation programme on patients with Huntington's disease: a pilot study." Clinical Rehabilitation 21:603-613. A technical paper which outlines a study on how rehabilitation affected patients over a longer time span. Data mentioned in the "Effectiveness of Physical Therapy" section was drawn from this study.
Last Modified: 05/22/2009
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