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Task specific training in Huntington's Disease: A randomised controlled feasibility trial

Quinn, Lori, Debono, Katy, Rosser, Anne Elizabeth, Nemeth, Andrea, Quarrell, Oliver, Rickards, Hugh, Tabrizi, Sarah, Trender-Gerhard, Iris, Kelson, Mark, Townson, Julia, Busse, Monica and TRAIN HD management group, 2014. Task specific training in Huntington's Disease: A randomised controlled feasibility trial. Journal of Neurology, Neurosurgery and Psychiatry 85 (1) , A66. 10.2522/ptj.20140123

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Abstract

Background. Motor learning principles suggest that interventions to promote mobility should incorporate goal-directed activities within the specific environmental context to achieve better outcomes. Aims: We aimed to determine the feasibility, safety and potential benefit of goal-directed, task-specific mobility training for individuals with mid-stage HD. Methods: Thirty individuals were enrolled and randomized into control or intervention group in this blinded, multi-centre trial. Training focused on walking, sit-to-stand and standing, twice a week for 8 weeks at home. Goal attainment scaling was used to individualize and direct the intervention. Time to complete 5 chair sit-to-stand repetitions (5CST) was recorded at each intervention session. Adherence and adverse events were monitored. Adjusted between-group comparisons on standardized outcome measures (blinded) at 8 and 16 weeks informed assessment of benefit. Results: Loss to follow up was minimal (2 participants); adherence in the intervention group was excellent (96.9%). Ninety-two percent (92%) of goals were achieved at the end of the intervention and 46% achieved much better than expected outcome; the majority of goals focused on improving walking endurance and confidence. Mean (95% CI) improvement in 5CST in intervention group was 5.5 sec (2.2,8.9). There was no clear evidence of benefit on standardized outcome measures at 8- or 16-week assessments. Conclusions. Most participants exceeded goal expectation with excellence adherence. While the programme was well received by people with HD and facilitated achievement of personal mobility goals, training intensity and specificity was likely insufficient to achieve systematic improvements in standardized outcome measures.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Healthcare Sciences
Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Neuroscience and Mental Health Research Institute (NMHRI)
Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
R Medicine > RZ Other systems of medicine
Publisher: BMJ Publishing Group Ltd
ISSN: 1468-330X
Funders: Huntington's Disease Association
Last Modified: 05 Feb 2019 16:53
URI: http://orca.cf.ac.uk/id/eprint/65096

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