[Rehabilitation in Huntington's Disease]. / Rehabilitative Therapien bei Morbus Huntington.

ABSTRACT

Huntington's disease (HD) is a chronic neurodegenerative disease for which as yet no disease-modifying therapy is available. Even at the early stage of the disease, HD patients suffer from motor and cognitive impairments. They are in need of physical, occupational and speech therapy or (inpatient) multidisciplinary rehabilitation. This paper reviews the available evidence for the usefulness of these therapeutic interventions. Studies using HD animal models have shown that motor training per se or as part of an enriched environment setting may have a positive impact on disease onset and progression. There are four clinical randomized controlled trials (RCT) showing beneficial effects of physical therapy (standardized home-based training program). In particular, inpatient neurological rehabilitation may have positive effects on activities of daily living (ADL) in HD patients. A non-controlled trial on multidisciplinary rehabilitation showed a reduction of oxidative stress and associated neurodegeneration, with another study even demonstrating an increase in the volume of the right caudate and the dorsolateral prefrontal cortex. Among the studies focusing on multidisciplinary rehabilitation, there is only one RCT. Further controlled studies are needed.