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亨廷顿舞蹈症康复治疗的最新进展:叙述性综述

Update of Rehabilitation in Huntington's Disease: Narrative Review.

作者信息

Kim Ki-Hong, Song Min-Keun

机构信息

Department of Physical & Rehabilitation Medicine, Chonnam National University Hospital, Gwangju, Korea.

Department of Physical & Rehabilitation Medicine, Chonnam National University Medical School, Gwangju, Korea.

出版信息

Brain Neurorehabil. 2023 Oct 31;16(3):e28. doi: 10.12786/bn.2023.16.e28. eCollection 2023 Nov.

Abstract

Huntington's disease (HD) is a neurodegenerative disease that has motor dysfunction, predominantly chorea, cognitive impairment, and psychiatric disturbances as symptoms. Treatment is directed to reduce the severity of symptoms, although there are few studies and no clinical guidelines for rehabilitation in HD. Therefore, this review aimed to establish an effective rehabilitation approach for HD according to the stage of the disease. In the early stage of HD, the motor symptoms are mild, and psychological symptoms occur. Treatment in this period should focus on aerobic and resistance exercises, task-specific training, secondary prevention education, cognitive training, and psychological management. In the middle stage of HD, the motor symptoms are more severe. Task-specific rehabilitation approaches, education for the patient and caregiver, functional respiratory exercises, activities of daily living training, multidisciplinary and multimodal daycare rehabilitation are helpful to patients in this stage. At the late stage of HD, most patients need complete support for activity of daily living. Mobility and balance evaluation and prevention strategies should be focused on for safety, and respiratory exercises and physical exercise to prevent complications in patients with severely impaired mobility should be considered based on the patient's condition. Programmed rehabilitation management based on the stage of the disease is effective for patients with HD.

摘要

亨廷顿舞蹈症(HD)是一种神经退行性疾病,其症状主要包括运动功能障碍(以舞蹈症为主)、认知障碍和精神紊乱。尽管针对HD康复的研究较少且尚无临床指南,但治疗旨在减轻症状的严重程度。因此,本综述旨在根据疾病阶段建立一种有效的HD康复方法。在HD的早期,运动症状较轻,且会出现心理症状。此阶段的治疗应侧重于有氧运动和抗阻运动、特定任务训练、二级预防教育、认知训练和心理管理。在HD的中期,运动症状更为严重。特定任务康复方法、对患者及照料者的教育、功能性呼吸锻炼、日常生活活动训练、多学科和多模式日间护理康复对该阶段的患者有益。在HD的晚期,大多数患者需要完全的日常生活活动支持。为了安全起见,应重点进行移动性和平衡评估及预防策略,并且应根据患者情况考虑进行呼吸锻炼和体育锻炼,以预防行动严重受限患者的并发症。基于疾病阶段的程序化康复管理对HD患者有效。

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