title: Development of a community-based exercise program for people diagnosed and at-risk for Huntington's disease: A clinical report.
abstract: BACKGROUND
  Given the neurodegenerative nature of Huntington's disease (HD), community-based exercise programs that meet the ongoing needs of those living with HD are needed. The genetic nature of HD warrants the inclusion of those at-risk for HD. The purpose of this clinical report is to describe an evidence-based approach to the design of a community-based exercise program to improve gait, balance, and fatigue for individuals diagnosed with and at-risk for HD.
  
  
  METHODS
  Based on the literature, clinical expertise and patient values, the program was designed to include four key features: (1) community-based group format for individuals with HD, caregivers, and those at-risk for HD; (2) individualized prescription within the group; (3) circuit training; and (4) use of outcome measures. PROGRAM IMPLEMENTATION AND OUTCOMES: The group met once weekly for 8 weeks for balance, strength, and cardiovascular fitness exercises. Three individuals participated, two diagnosed with HD and 1 considered "at-risk" for HD. Pre- and post- outcome measures included the 10 meter walk test, Berg Balance Scale, Fatigue Impact Scale, and the Timed Up and Go. Participants demonstrated improvement or maintenance of abilities in all measures with no adverse events.
  
  
  CONCLUSIONS
  This clinical report describes the integration of the evidence, clinical expertise, and patient values to develop and implement individualized, community-based exercise groups, aimed to improve balance, gait speed, and fatigue measures for persons with HD and those at-risk. Post-program reflections and recommendations for those who are interested in developing similar programs in other communities are described.
authors.affiliation: a Neuroresident and Adjunct Faculty , Bellarmine University , Louisville , KY , USA.
authors.forename: Dalie
authors.initials: D
authors.lastname: Clark
authors.affiliation: b Physical Therapy Program, Bellarmine University , Louisville , KY , USA.
authors.forename: Megan M
authors.initials: MM
authors.lastname: Danzl
authors.affiliation: b Physical Therapy Program, Bellarmine University , Louisville , KY , USA.|c Norton Healthcare , Louisville , KY , USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ulanowski
mesh_terms: D000328:Adult; D003153:Community Health Services; D005080:Exercise Test; D005081:Exercise Therapy; D005221:Fatigue / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005684:Gait; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D053580:Muscle Strength; D004856:Postural Balance; D016730:Program Development; D015397:Program Evaluation; D020127:Recovery of Function; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Community based; Huntington’s disease; exercise