title: Practice, progress and future directions for physical therapies in Huntingtons disease.
abstract: Physical therapies and exercise may have potential as a disease modifying agent in Huntington's disease (HD) and in recent years, there have been several small scale feasibility studies that have shown benefit as a result of physical interventions. When evaluating complex physical interventions, a phased approach using mixed methodology designs that report specific intervention components, adherence, acceptability, adverse events and defined intervention protocols is important for replication and planning of future trials and to ensure potential for implementation in clinical practice. A narrative review of the available literature related to physical activity, physical therapy and exercise in people with HD was performed using a population, intervention, comparison and outcome (PICO) approach. Eight studies met specific inclusion criteria and were reviewed in terms of their systematic conduct and reporting standards. All of the studies (n = 8) provided details of intervention including location and duration. The majority of interventions included balance training activities in combination with other complex activities of daily living that required therapist supervision. Two of the interventions were home based, the remainder were facility or hospital based. None of the studies reported adverse events whilst only 3/8 reported adherence rates which were ranging from 60-80%. In general, limited detail was provided on the specific individual components of the interventions. This review of primary publications and conference proceedings, suggests that researchers working in the field need to focus on clearer reporting of intervention protocols so as to generate a clearer understanding of the impact of exercise and physical therapies on the symptoms of HD, as well as any potential synergistic role alongside the impending disease-modifying interventions.
authors: School of Health Care Studies, Cardiff University, Cardiff, UK.  busseme@cardiff.ac.uk
authors: Monica
authors: M
authors: Busse
authors: School of Health Care Studies, Cardiff University, Cardiff, UK.
authors: Hanan
authors: H
authors: Khalil
authors: Cardiff Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK.
authors: Simon
authors: S
authors: Brooks
authors: School of Health Care Studies, Cardiff University, Cardiff, UK.
authors: Lori
authors: L
authors: Quinn
authors: Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine and Cardiff Brain Repair Group, School of Biosciences, Cardiff University, Cardiff, UK.
authors: Anne
authors: A
authors: Rosser
mesh_terms: D019317:Evidence-Based Medicine; D005260:Female; D005544:Forecasting; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000534:rehabilitation*; D008297:Male; D026741:Physical Therapy Modalities / Q000639:trends*; D010818:Practice Patterns, Physicians' / Q000639:trends*; D015995:Prevalence; D016896:Treatment Outcome
keywords: Huntington's disease; chorea; exercise; physical activity; physical therapy; physiotherapy; rehabilitation