Article

Task-specific training may be a suitable intervention to address
mobility limitations in people with Huntington disease (HD). The aim
of this study was to assess the feasibility and safety of goal-directed,
task-specific mobility training for individuals with mid-stage HD. DESIGN: This
study was a randomized, blinded, feasibility trial; participants were randomly
assigned to control (usual care) and intervention groups. SETTING: This multisite
study was conducted in 6 sites in the United Kingdom. PATIENTS: Thirty
individuals with mid-stage HD (13 men, 17 women; mean age=57.0 years, SD=10.1)
were enrolled and randomly assigned to study groups. INTERVENTION: Task-specific
training was conducted by physical therapists in participants' homes, focusing on
walking, sit-to-stand transfers, and standing, twice a week for 8 weeks. Goal
attainment scaling was used to individualize the intervention and monitor
achievement of personal goals. MEASUREMENTS: Adherence and adverse events were
recorded. Adjusted between-group comparisons on standardized outcome measures
were conducted at 8 and 16 weeks to determine effect sizes. RESULTS: Loss to
follow-up was minimal (n=2); adherence in the intervention group was excellent
(96.9%). Ninety-two percent of goals were achieved at the end of the
intervention; 46% of the participants achieved much better than expected
outcomes. Effect sizes on all measures were small. LIMITATIONS: Measurements of
walking endurance were lacking. CONCLUSIONS: The safety of and excellent
adherence to a home-based, task-specific training program, in which most
participants exceeded goal expectations, are encouraging given the range of
motivational, behavioral, and mobility issues in people with HD. The design of
the intervention in terms of frequency (dose), intensity (aerobic versus
anaerobic), and specificity (focused training on individual tasks) may not have
been sufficient to elicit any systematic effects. Thus, a larger-scale trial of
this specific intervention does not seem warranted.
CI - (c) 2014 American Physical Therapy Association.

Langue : ANGLAIS