Session Title: Neurological Rehabilitation Case and Research Report
Session Time: 12:30pm-2:00pm
Location: Research Hub - Kiosk 5
Disclosures: Angelina M. Ciavarella, PT, DPT: Nothing to disclose
Case Description: A female patient with Huntington’s disease (HD) wanted to participate in a cardiovascular/strength training program. A literature review was performed to investigate the safety and efficacy. Patient was determined to be appropriate for exercise according to clinical guidelines (Quinn and Busse, 2012). A cardiovascular/strength training program was selected from a RCT (Quinn, et al., 2016). Therapist initiated training with the patient 1×/week. Patient was given detailed information (pictures and handouts) on performing home exercises 2×/week. The nurse coordinator at patient’s ALF was informed of the program and confirmed patient has access to cardiovascular equipment (NuStep).
Setting: Outpatient neuro rehabilitation clinic.
Patient: 50-year-old female with HD Category C, early-mid stage of HD (Quinn and Busse, 2012) Co-morbidities: RA in all joints, smoker, declining cognition, poor caregiver support.
Assessment/Results: Patient attended 5/10 PT visits. She tolerated only 5 minutes on NuStep, resistance 1.0, at 60% age predicted max HR. She tolerated 2 sets × 10 reps of 4 strengthening exercises. Outcome measures Initial: 5× sit to stand: 19.54s 25 foot walk (with 4WW): 11.84s self-selected, 7.46s fast 6 minute walk test: unable 10 weeks: 5× sit to stand: 21s 25 foot walk (with 4WW): 8.8s self-selected, 7.43s fast 6 minute walk test: unable
Discussion: This patient was safe to participate in cardiovascular and strength training; however, cognitive deficits as well as lack of caregiver support led to poor carryover with home program. Missed visits due to transportation issues, patient forgetting, or illness led to poor attendance for PT visits. Overall, she did not make significant improvements in most outcome measures.
Conclusion: Patients with HD may be appropriate for cardiovascular and strength training 3×/week. However, considerations should be made including stage of HD, cognitive status, caregiver support, weight loss, and co-morbidities as each can limit the feasibility and execution of a program.
Level of Evidence: Level V
To cite this abstract in AMA style:Ciavarella AM. Investigation and Execution of a Therapeutic Exercise Program in a Patient with Huntington’s Disease [abstract]. PM R. 2019; 11(S2)(suppl 2). https://pmrjabstracts.org/abstract/investigation-and-execution-of-a-therapeutic-exercise-program-in-a-patient-with-huntingtons-disease/. Accessed September 22, 2023.
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