October 02, 2001
This might be beneficial in working with insurance/doctors to get
PT script approved.
The following is a research and clinical article of interest to physical
therapists who work with HD patients. This information was originally
published in the Degenerative Diseases SIG newsletter (Volume 1,
Issue 2, January, 2001).
Submitted by Lori Quinn, EdD, PT
Email: Lori_quinn@nymc.eduAs with many of the neuro-degenerative diseases, specific literature related
to physical therapy interventions is lacking. In fact, to date there have
been no case studies or controlled intervention studies reported in the literature.
What is being developed is a larger number of studies aimed at understanding
the underlying impairments and motor control deficits related to Huntington's
Disease. This is an important first step in developing clinical interventions.
Several articles listed below provide information most relevant to physical
therapists in attempting to "bridge the gap" between the understanding of
HD neurophysiology, and developing physical therapy programs which benefit
our patients and ultimately work towards improving their quality of life.
Hausdorff et al and Reynolds et al present analyses of gait
impairments in individuals with HD.
Louis et al discusses the incidence, prevalance and
characteristics of dystonia, which can occur in up to
95% of patients, and can be even more disabling
- A recent article published in Nature has suggested that
environmental enrichments in mice with HD delayed the
onset of symptoms of the disease. Mice who were genetically
engineered to develop a condition similar to Huntington's
Disease were placed in cages that were considered "enriched",
containing objects that they could manipulate and play with,
versus "non-enriched" environments, with only bedding and
feed. The authors speculate that "environmental enrichment
may overcome deficiencies of synaptic plasticity...and help
to improve the defects in HD mice".
- Two papers describing clinical interventions for individuals with
HD were published in Clinical Management. Although published
more than 5 years ago, these articles provide a nice overview
of physical therapy programs for individuals with HD.
Inez Peacock and Suzanne Imbriglio are both therapists who
have been working with patients with HD for a number of years,
and both have wonderful insights as to the challenges facing
therapists working with this population.
Hausdorff JM, Cudkowicz ME, Firtion R, Wei JY, & Goldberger AL.
Gait variability and basal ganglia disorders: stride-to-stride variations
of gait cycle timing in Parkinson's disease and
Huntington's disease. Mov Disord. 1998;13(3):428-437.
Imbriglio, S. Huntington's Disease at mid-stage.
Clinical management. 1992; 12(5):62-72.
Louis ED, Lee P, Quinn L, Marder K.
Dystonia in Huntington's Disease: prevalence and clinical characteristics.
Mov Disord. 1999;14(1): 95-101.
Peacock, I. A physical therapy program for Huntington's disease patients.
Clinical management. 7(1):22-3,34.
Reynolds NC, Myklebust JB, Prieto TE, Myklebust BM.
Analysis of gait abnormalities in Huntington's disease.
Arch Phys Med Rehabil. 1999;80(1): 59-65.
van Dellen A, Blakemore C, Deacon R, York D, Hannan AJ.
Delaying the onset of Huntington's in mice.
Nature. 2000; 13:721-2.