Inpatient multidisciplinary rehabilitation programme for postural and gait stability in Huntington's disease a pilot study
Abstract
Aim: Postural and gait instability in Huntington's disease (HD) is a key component of the motor symptomatology which contributes to an increased risk of falls. Rehabilitation is considered beneficial in postural and gait stability treatment.
We aimed to explore the feasibility and the short-and long-term effects of an inpatient multidisciplinary rehabilitation program on postural and gait stability in subjects with HD. Methods: A sample of 13 subjects with HD but with no severe cognitive deficit or depression underwent a 3-week specific inpatient rehabilitation program focused on postural and gait stability.
Patients were examined at the baseline, after the completion of rehabilitation, and then 1 month and 3 months after the end of the program. The testing included: gait stability examination (Dynamic Gait Index; DGI), posturography examination of postural stability on a stable (PSS) and 20% unstable (PSU) platform and the total motor score evaluation by Unified Huntington's Disease Rating Scale (UHDRS).
Results: There was a significant improvement lasting 3 months in PSS and a significant improvement in DGI immediately after the rehabilitation. There was no significant improvement in the PSU and UHDRS total motor score.
Conclusion: Specific rehabilitation methods are safe and feasible and may be beneficial in the treatment of postural and gait instability in patients with early and mid-stage HD. The postural instability improvement measured by PSS persisted for at least 3 months.
The gait stability improvement in DGI did not persist after 1 month. We found no improvement in PSU.
This exploratory study offers a sample of a specific rehabilitation protocol for stability training in HD.