Development of Physiotherapy Guidance and treatment-based Classifications for People With Huntington’s Disease

Quinn, Lori; Busse, Monica

doi:10.2217/nmt.11.67

Cited by 18 publications

(12 citation statements)

References 26 publications

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“…In an effort to facilitate the development of theoretically driven interventions in HD, our group has developed Physical Therapy Guidelines for HD that utilize Treatment Based Classifications (TBCs) 21,22 (Table 1)…”

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confidence: 99%

A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series

Fritz

Busse

Jones

et al. 2017

Journal of Neurologic Physical Therapy

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These cases provide proof-of-principle to support use of treatment-based classifications for physical therapy management in individuals with HD. Traditional classification of early-, mid-, and late-stage disease progression may not reflect patients' true capabilities; those with late-stage HD may be as responsive to interventions as those at an earlier disease stage.Video Abstract available for additional insights from the authors (see Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A172).

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confidence: 99%

A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series

Fritz

Busse

Jones

et al. 2017

Journal of Neurologic Physical Therapy

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“…The authors discussed the results in terms of application to 7 treatment-based classifications to assist physical therapy treatment planning in HD. 6,7 The guideline is designed to answer the following PICO question: for individuals with HD (all stages) across practice settings, what is the effect of physical therapy interventions (e.g., exercise, physical activity interventions, task-specific training, gait and balance training, and respiratory training) on outcomes of mobility, balance, physical fitness, physical activity, respiratory function, and patient-reported outcomes compared with no intervention, wait list control, or social contact control?…”

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confidence: 99%

Clinical recommendations to guide physical therapy practice for Huntington disease

et al. 2020

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ObjectiveIn the past decade, an increasing number of studies have examined the efficacy of physical therapy interventions in people with Huntington disease (HD). MethodsWe performed a mixed-methods systematic review using Joanna Briggs Institute (JBI) methodology and included experimental and observational study designs. The search resulted in 23 quantitative studies and 3 qualitative studies from which we extracted data using JBI standardized extraction tools. Results of this review suggested that physical therapy interventions may improve motor impairments and activity limitations in people with HD. Here, we expand on the review findings to provide specific recommendations to guide clinical practice. ResultsWe recommend the following specific physical therapy interventions for people with HD: aerobic exercise (grade A evidence), alone or in combination with resistance training to improve fitness and motor function, and supervised gait training (grade A evidence) to improve spatiotemporal features of gait. In addition, there is weak (grade B) evidence that exercise training improves balance but does not show a reduction in the frequency of falls; inspiratory and expiratory training improves breathing function and capacity; and training of transfers, getting up from the floor, and providing strategies to caregivers for involvement in physical activity in the midstages of HD may improve performance. There is expert consensus for the use of positioning devices, seating adaptations, and caregiver training in late stages of HD. ConclusionsThere is strong evidence to support physical therapy interventions to improve fitness, motor function, and gait in persons with HD.This clinical practice guideline provides clinical recommendations for physical therapy interventions and patientreported outcomes for individuals with Huntington disease (HD). The target audience are rehabilitation professionals and referring physicians providing care to persons with HD. The recommendations should be interpreted by the clinician in the context of their specific clinical practice and the patient's impairments, goals, and disease stage, while considering the potential for harm.We used the Joanna Briggs Institute (JBI) method for critical appraisal of research, assignment of evidence to the literature, and assignment of levels of strength to the recommendation. The JBI method allows for inclusion of experimental study designs other than randomized controlled trial, such as observational study designs, retrospective and prospective cohort studies, expert consensus, and qualitative studies. The inclusion of a wide range of study designs (i.e., all levels of evidence) was critical, given the paucity of randomized controlled trials involving physical therapy in HD. The guideline is organized according to the level of evidence and the grade of the recommendation (tables 1 and 2) underpinning action statements. A summary of action statements, a description of each action statement, and research recommendations are provided.Each individual articl...

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“…These interventions widely comprise "Any bodily movement produced by skeletal muscles that requires energy expenditure" and any type of structured exercise (15) including gait and balance training, video-gaming (16)(17)(18) and cognitive behaviour interventions (19)(20)(21). However, although physical activities are promoted as an essential part of the clinical management across RNCs, evidence supporting physical activity interventions is still lacking in these conditions (22)(23)(24)(25)(26)(27). To date, there are significant gaps in understanding about which types of activities maintain physical functioning and increase participation in activities and quality of life across RNCs.…”

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confidence: 99%

Physical activity and exercise interventions for people with rare neurological disorders: a scoping review of systematic reviews

Buscemi

Boaz²,

Dawes

et al. 2019

Preprint

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Background: People living with rare neurological conditions (RNCs) often face common physical, cognitive and psychological challenges that lead to reduced physical activity and associated deconditioning. Physical activity interventions are routinely utilised to address disease specific limitations with the intention of promoting participation in people with RNCs. This scoping review aimed to synthesise the body of evidence for such interventions as they are applied across a wide range of RNCs. Methods: We undertook a scoping review of systematic reviews of any type of physical activity and exercise interventions for adults with neuromuscular diseases, motor neurone disease, Huntington’s disease, progressive supranuclear palsy, multiple system atrophy, inherited ataxias and hereditary spastic paraplegia. The reviews were included if they reported at least one outcome that aimed to increase physical activity level at either the body structure/function, activity and/or participation levels. Results: Sixty-two articles were full-text screened of which 27 were included. Most studies involved interventions in people with neuromuscular diseases. No reviews of interventions in hereditary spastic paraparesis were identified. The majority of reviews included studies of structured exercise using outcome measures at the level of body function and functional activity. Interventions were grouped as: i) combined interventions; ii) muscle strength training; iii) respiratory training; iv) aerobic training. Frequency, intensity, time and type of structured exercise utilised varied considerably across studies. Most studies were methodologically limited by small sample sizes, variation in exercise dose and training duration.Conclusions: To date, primary attention has been given to structured exercise interventions, which have demonstrated to have a low to uncertain level of evidence. Novel approaches to implementing common interventions and modalities are needed to increase accessibility and engagement in physical activity irrespective of disease type. Further exploration is warranted to achieve consensus on outcome measures that reflect areas of importance and relevance to people with RNCs.

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Development of Physiotherapy Guidance and treatment-based Classifications for People With Huntington’s Disease

Cited by 18 publications

References 26 publications

A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series

A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series

Clinical recommendations to guide physical therapy practice for Huntington disease

Physical activity and exercise interventions for people with rare neurological disorders: a scoping review of systematic reviews

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