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A pilot study of influences on physical activity level and exercise capacity in people with Huntington's disease [Abstract]

Jones, Una Frances, Busse, Monica, Enright, Stephanie and Rosser, Anne Elizabeth 2011. A pilot study of influences on physical activity level and exercise capacity in people with Huntington's disease [Abstract]. Physiotherapy 97 (s1) , eS570. 10.1016/j.physio.2011.04.002

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Abstract

Purpose: The purpose of this studywas to investigate disease specific and respiratory function measures that may influence physical activity levels and exercise capacity in people with Huntington’s disease. Relevance: Huntington’s disease (HD) is a neurodegenerative condition resulting in motor, cognitive and behavioural dysfunction. As with Parkinson’s disease and multiple sclerosis,physiotherapy management focuses on maintaining functional ability as long as possible. Ability to function and participate in activities of daily life will depend upon the pathophysiology of the condition as well as respiratory function. There is limited evidence concerning factors that influence physical activity levels and exercise capacity in people with HD. The results of this study will enable physiotherapists to use an evidence-based approach to the assessment and management of patients’ problems. Participants: Eighteen (7 female; mean (SD) age 51.2 (13.6) patients with HD were selected from a HD research and management clinic. Inclusion criteria were: symptomatic of HD;able to walk with or without assistance. Methods: A cross-sectional observational method was used. Descriptive data collected were: age; total functional capacity (TFC) from standardised questionnaire. Dependant variables measured were: physical activity level (MET-minutes/week)from International Physical Activity Questionnaire (IPAQ)short form; exercise capacity (meters) measured by six minute walk test (6 MWT). Independent variables measured were: Forced Vital Capacity in litres (FVC), a global measure of respiratory function measured following American Thoracic Society Guidelines; Unified Huntington’s Disease Rating Scale-Total Motor Score (UHDRS-TMS), a disease specific measure of motor function. Analysis: Data were analysed using Pearson’s correlations and where appropriate stepwise linear regression. Results: Descriptive data of all variables are as follows: mean (SD) TFC was 4.35 (2.4) (available range 0–14, higher scores indicate greater functional level); IPAQ median 328MET-minutes/week (low activity level); 6MWT mean (SD) was 191.95 meters (105.78); UHDRS-TMS mean (SD) 61.73 (12.02) (available range 0–120, higher scores indicating decreased motor function); FVC mean (SD) 2.19 L (1.00). FVC correlated with 6MWTand IPAQ (r = 0.44, 0.61 respectively); UHDRS correlated negatively with 6MWT and IPAQ (r =−0.63, r =−0.42 respectively). Linear regression results: UHDRS-TMS predicted 6MWT (R2 = 0.40, 6MWT= 536.1–5.6 (UHDRS-TMS), FVC was excluded; FVC predicted IPAQ (R2 = 0.37, IPAQ=−135.2 + 225.6 (FVC), UHDRS-TMS was excluded. Conclusions: In patients with HD, 6MWT is more influenced by UHDRS-TMS than respiratory function, however respiratory function predicted self-reported physical activity level. Slow gait due to motor function impairment may curtail 6MWTcompletion, while respiratory function may limit daily activities. Based on this study, it appears that the ability to function and participate in activities is multifactorial which requires consideration for physiotherapy management of people with neurodegenerative conditions. The results of this study are limited to patients who reported low activity levels and lowTFC scores; but are part of a larger study which will increase the power of the study. Implications: Ability to function and participate in activities is dependent on underlying disease process and respiratory function, and both elements should be considered when assessing and developing management strategies for people with neurodegenerative conditions.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
Healthcare Sciences
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Neuroscience and Mental Health Research Institute (NMHRI)
Subjects: R Medicine > R Medicine (General)
R Medicine > RC Internal medicine
Additional Information: World Physical Therapy 2011 Abstracts
Publisher: Elsevier
ISSN: 0031-9406
Funders: Physiotherapy Research Foundation, UK, Research Capacity Building Collaboration Wales
Last Modified: 09 Mar 2018 20:18
URI: http://orca.cf.ac.uk/id/eprint/30376

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