Task-specific training in Huntington disease: a randomized controlled feasibility trial.

BACKGROUND

Task-specific training may be a suitable intervention to address mobility limitations in people with Huntington disease (HD).

OBJECTIVE

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.