School of Healthcare Sciences, Cardiff University, Cardiff, Wales.
Teachers College, Columbia University, New York, NY, USA.
Disabil Rehabil. 2021 Jun;43(11):1565-1575. doi: 10.1080/09638288.2019.1671501. Epub 2019 Oct 7.
Huntington's disease is an autosomal dominant neurodegenerative disease. Progressive physical, behavioural and cognitive impairments cause loss of independent function. Physical activity interventions are important components of comprehensive intervention strategies and may help alter the functional decline trajectory. Qualitative research has an important role to play in developing theoretically sound, well-defined physical activity interventions in Huntington's disease.
Eight focus groups were conducted with people with prodromal to late stage Huntington's disease, caregivers (family members/formal), and healthcare professionals. An analytical coding framework was developed from the data and Levanthal's self-regulation model to assist analysis.
Key themes were identified: evolving representations of Huntington's disease and physical activity; varying social environment of the person with Huntington's disease and the impact on physical activity; achieving physical activity participation while coping with the nuances of Huntington's disease. Levanthal's model facilitated understanding of physical activity experiences, however with progression, self-regulation of activities needs to become more collaborative with caregivers. A modified self-regulation model specific to physical activity in Huntington's disease is presented. Using a novel approach to generate new understanding of physical activity across the Huntington's disease lifespan facilitated development of an original and significant theoretical foundation to underpin development of a range of much needed physical activity and exercise interventions in Huntington's disease.Implications for rehabilitationSocial and familial context of individuals with HD is a key consideration for health care professionals supporting physical activity participation.Strategies such as using physical activity as a way of achieving control and adjusting expectations can help people with HD to continue to be active.People with HD adapt physical activity from high level to more functional activities with symptom progression.
亨廷顿病是一种常染色体显性神经退行性疾病。进行性的身体、行为和认知障碍导致独立功能丧失。身体活动干预是综合干预策略的重要组成部分,可能有助于改变功能下降的轨迹。定性研究在亨廷顿病中开发理论上合理、定义明确的身体活动干预措施方面具有重要作用。
对处于前驱期至晚期亨廷顿病的患者、照顾者(家庭成员/正式)和医疗保健专业人员进行了 8 次焦点小组讨论。从数据和莱文塔尔的自我调节模型中开发了一个分析编码框架来辅助分析。
确定了关键主题:亨廷顿病和身体活动的不断变化的表现;亨廷顿病患者的社会环境不同及其对身体活动的影响;在应对亨廷顿病细微差别的同时实现身体活动参与。莱文塔尔的模型有助于理解身体活动的体验,但随着病情的进展,活动的自我调节需要与照顾者更加协作。提出了一种针对亨廷顿病身体活动的改良自我调节模型。使用一种新颖的方法来生成亨廷顿病整个生命周期中身体活动的新理解,为开发一系列急需的亨廷顿病身体活动和运动干预措施提供了原创和重要的理论基础。
亨廷顿病患者的社会和家庭环境是支持身体活动参与的医疗保健专业人员的关键考虑因素。使用身体活动作为实现控制和调整预期的一种方式等策略可以帮助亨廷顿病患者继续保持活跃。随着症状的进展,亨廷顿病患者会将身体活动从高水平调整为更具功能性的活动。