Travis M Cruickshank1,2, Alvaro P Reyes3, Luis E Penailillo4, Tim Pulverenti1, Danielle M Bartlett1, Pauline Zaenker1, Anthony J Blazevich1,5, Robert U Newton1,6, Jennifer A Thompson1, Johnny Lo1, Mel R Ziman1,7. 1. School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia. 2. Perron Institute for Neurological and Translational Science, Perth, Western Australia, Australia. 3. Facultad de Ciencias de la Rehabilitacion, Universidad Andres Bello, Santiago, Chile. 4. Exercise Physiology Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile. 5. Centre of Exercise and Sports Science, Edith Cowan University, Perth, Western Australia, Australia. 6. UQ Centre for Clinical Research, University of Queensland, Brisbane, Queensland, Australia. 7. School of Pathology and Laboratory Medicine, University Western Australia, Perth, Western Australia, Australia.
Abstract
OBJECTIVE: The primary objective of this trial was to evaluate the effects of outpatient multidisciplinary therapy, compared to usual care, on measures of physical function and muscle strength in patients with manifest Huntington's disease (HD). METHODS:Twenty-two patients with clinically verified HD were randomized to receive 36 weeks of outpatient multidisciplinary therapy or usual care. Outpatient multidisciplinary therapy comprised 9 months of supervised exercise, cognitive therapy and self-directed home-based exercise. Usual care consisted of standard medical care. Patients were assessed at 0 and 36 weeks by blinded assessors. The primary outcome was changed in mobility as measured by the 10-m Timed Walk Test. Secondary outcome measures included changes in manual dexterity (Timed Nut and Bolt Test), balance (Berg Balance Scale), cardiorespiratory endurance (6-Minute Walk Test) and upper and lower extremity muscle strength (isokinetic and isometric muscle strength and 10 Repetition Sit-to-Stand Tests). RESULTS: Patients receiving outpatient multidisciplinary therapy demonstrated significantly enhanced manual dexterity (P < 0.05) and lower extremity muscle strength (P < 0.05) than patients receiving usual care. No significant differences in mobility, balance, cardiorespiratory endurance and upper extremity strength outcomes were observed between groups after the intervention period. There were no adverse events associated with multidisciplinary therapy. CONCLUSION: Our findings suggest that outpatient multidisciplinary therapy has positive effects on manual dexterity and muscle strength, but no meaningful effects on mobility, balance, cardiorespiratory endurance and upper extremity muscle strength in patients with HD. Larger randomized controlled trials are needed to confirm these preliminary findings.
RCT Entities:
OBJECTIVE: The primary objective of this trial was to evaluate the effects of outpatient multidisciplinary therapy, compared to usual care, on measures of physical function and muscle strength in patients with manifest Huntington's disease (HD). METHODS: Twenty-two patients with clinically verified HD were randomized to receive 36 weeks of outpatient multidisciplinary therapy or usual care. Outpatient multidisciplinary therapy comprised 9 months of supervised exercise, cognitive therapy and self-directed home-based exercise. Usual care consisted of standard medical care. Patients were assessed at 0 and 36 weeks by blinded assessors. The primary outcome was changed in mobility as measured by the 10-m Timed Walk Test. Secondary outcome measures included changes in manual dexterity (Timed Nut and Bolt Test), balance (Berg Balance Scale), cardiorespiratory endurance (6-Minute Walk Test) and upper and lower extremity muscle strength (isokinetic and isometric muscle strength and 10 Repetition Sit-to-Stand Tests). RESULTS:Patients receiving outpatient multidisciplinary therapy demonstrated significantly enhanced manual dexterity (P < 0.05) and lower extremity muscle strength (P < 0.05) than patients receiving usual care. No significant differences in mobility, balance, cardiorespiratory endurance and upper extremity strength outcomes were observed between groups after the intervention period. There were no adverse events associated with multidisciplinary therapy. CONCLUSION: Our findings suggest that outpatient multidisciplinary therapy has positive effects on manual dexterity and muscle strength, but no meaningful effects on mobility, balance, cardiorespiratory endurance and upper extremity muscle strength in patients with HD. Larger randomized controlled trials are needed to confirm these preliminary findings.
Authors: C Painous; N J H van Os; A Delamarre; I Michailoviene; M J Marti; B P van de Warrenburg; W G Meissner; A Utkus; C Reinhard; H Graessner; M A Tijssen Journal: Eur J Neurol Date: 2020-06-19 Impact factor: 6.089
Authors: Tamine T C Capato; Rubens G Cury; Juliana Tornai; Erich T Fonoff; Renata Guimarães; Manoel T Jacobsen; Mônica S Haddad; Egberto R Barbosa Journal: Front Rehabil Sci Date: 2022-04-14