title: Task-specific training in Huntington disease: a randomized controlled feasibility trial.
abstract: 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.
  
  
  METHODS
  This study was a randomized, blinded, feasibility trial; participants were randomly assigned to control (usual care) and intervention groups.
  
  
  METHODS
  This multisite study was conducted in 6 sites in the United Kingdom.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: L. Quinn, PT, PhD, School of Healthcare Sciences, Cardiff University, Cardiff, United Kingdom.
authors.forename: Lori
authors.initials: L
authors.lastname: Quinn
authors.affiliation: K. Debono, BSc AnatomicalScience(Hons), BSc Physiotherapy, MCSP, School of Healthcare Sciences, Cardiff University.
authors.forename: Katy
authors.initials: K
authors.lastname: Debono
authors.affiliation: H. Dawes, PhD, MMedSci, Movement Science Group, Oxford Brookes University, Oxford, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Dawes
authors.affiliation: A.E. Rosser, PhD, MB, BChir, BA(Hons), Schools of Medicine and Biosciences, Cardiff University.
authors.forename: Anne Elizabeth
authors.initials: AE
authors.lastname: Rosser
authors.affiliation: A.H. Nemeth, MB, BS, DPhil, CCST, Department of Clinical Genetics, Churchill Hospital, Oxford.
authors.forename: Andrea H
authors.initials: AH
authors.lastname: Nemeth
authors.affiliation: H. Rickards, MB, ChB, MMedSci, MRCPsych, MD, FRCPsych, The Barberry Centre, Birmingham, United Kingdom.
authors.forename: Hugh
authors.initials: H
authors.lastname: Rickards
authors.affiliation: S.J. Tabrizi, FRCP, PhD, FMedSci, BSc(Hons), Department of Neurodegenerative Diseases, UCL Institute of Neurology, University College London, Queen Square, London, United Kingdom.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Tabrizi
authors.affiliation: O. Quarrell, MD, FRCP, BSc, Sheffield Children's Hospital, Sheffield, United Kingdom.
authors.forename: Oliver
authors.initials: O
authors.lastname: Quarrell
authors.affiliation: I. Trender-Gerhard, MD, Institute of Human Development, University of Manchester, Manchester, St Mary's Hospital/Central Manchester Foundation Trust.
authors.forename: Iris
authors.initials: I
authors.lastname: Trender-Gerhard
authors.affiliation: M.J. Kelson, PhD, MSc, BSc, South East Wales Trial Unit, Cardiff University School of Medicine.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Kelson
authors.affiliation: J. Townson, BA(JointHons), South East Wales Trial Unit, Cardiff University School of Medicine.
authors.forename: Julia
authors.initials: J
authors.lastname: Townson
authors.affiliation: M. Busse, PhD, MSc(Med), BSc(Med)Hons, MCSP, BSc(Physiotherapy), School of Healthcare Sciences, Cardiff University, Ty Dewi Sant, Heath Park, Cardiff, CF14 4XN United Kingdom. busseme@cardiff.ac.uk.
authors.forename: Monica
authors.initials: M
authors.lastname: Busse
mesh_terms: D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006040:Goals; D006699:Home Care Services; D006801:Humans; D006816:Huntington Disease / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D020127:Recovery of Function; D013647:Task Performance and Analysis