A Randomized Feasibility Study of a 12-Week Community-Based Exercise Program for People With Huntington's Disease

Busse, Monica PhD; Quinn, Lori EdD; Debono, Katy BSc; Jones, Karen MSc; Collett, Johnathan PhD; Playle, Rebecca PhD; Kelly, Mark PhD; Simpson, Sharon PhD; Backx, Karianne PhD; Wasley, David PhD; Dawes, Helen PhD; Rosser, Anne PhD; the Members of the COMMET-HD Management Group

Journal of Neurologic Physical Therapy: December 2013 - Volume 37 - Issue 4 - p 149–158
doi: 10.1097/NPT.0000000000000016
Research Articles
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Background and Purpose: The beneficial role of exercise as a treatment approach in Huntington's disease (HD) has support from both preclinical work and small-scale studies; however, there have been no controlled studies of gym-based exercise in people with HD. This phase 2 randomized trial (ISRCTN 59910670) assessed feasibility, safety, acceptability, and benefit of a structured exercise program.

Methods: Thirty-one participants (16 men; mean [SD] age = 50.4 [11.4] years) were randomly allocated to intervention (n = 16) or control group (usual care; n = 15). The intervention entailed a weekly supervised gym session of stationary cycling and resistance exercises, and a twice weekly independent home-based walking program. Retention and adherence rates and adverse events were recorded. Acceptability was determined from subjective reports of tolerability and physiological measures recorded during the gym sessions. Assessment of benefit included measures of physical abilities, disease severity, and quality of life (36-Item Short Form Health Survey). Analysis of covariance was used to test outcomes of interest.

Results: The retention rate was 81% (9 of the 11 individuals who started the intervention completed it) and of the 9 who completed the program, 7 attended more than 75% (9/12) of the gym sessions. There were no related adverse events and the intervention was well tolerated by most participants. The between-group effect estimate for the Mental Component Summary score of the 36-Item Short Form Health Survey (n = 9; intervention, n = 13; control) was 7 (95% CI: 0.4–13.7) Moderate effect sizes for cognitive outcomes and measures of walking were also observed.

Discussion and Conclusions: Observed effect sizes for clinical outcomes suggest the structured exercise program has benefit for persons with HD; larger scale trials are warranted.

Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A60) for more insights from the authors.

School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom (M.B., L.Q., K.D., K.J.); Movement Science Group, Faculty of Health and Life Sciences, Oxford Brookes University, Oxford, United Kingdom (J.C., H.D.); and South East Wales Trials Unit, Institute for Translation, Innovation, Methodology and Engagement, School of Medicine Cardiff University (R.P., M.J.K., S.A.S.), Cardiff Metropolitan University, Cardiff School of Sport (K.B., D.W.), Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University (A.R.), and Cardiff Brain Repair Group, School of BioSciences, Cardiff University (A.R.), Cardiff, United Kingdom. COMMET-HD management group members are Karianne Backx, Monica Busse, Johnny Collett, Helen Dawes, Katy Debono, Sarah Hunt, Karen Jones, Mark Kelly, Andrea H. Nemeth, Rebecca Playle, Lori Quinn, Anne Rosser, Sharon Simpson, and David Wasley.

Correspondence: Monica Busse, PhD, School of Health Care Sciences, Cardiff University, Ty Dewi Sant, Heath Park, Cardiff CF14 4XN, United Kingdom (busseme@cf.ac.uk)

This work has been presented in an abstract format at the European Huntington's Disease Network Annual Plenary Meeting Stockholm, September 2012 with proceedings published in Journal of Neurology Neurosurgery and Psychiatry 83(S1), pp. A58-A59. (10.1136/jnnp-2012–303524.182).

Research funding for this study was from National Institute for Social Care and Health Research, Wales.

Trial Registration number: ISRCTN 59910670.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.jnpt.org).

The authors have no conflicts of interest to declare.

© 2013 Neurology Section, APTA