Huntington ’s Disease (HD) is a neurodegenerative
disease that is cause by genetic defect. Normally the DNA sequences
cytosine-adenine-guanine (CAG) is repeated 10-28 times in a
healthy person but HD patients has 36-120 repetitions. Since, it is passed
through families, the number seems to increase. The more the CAG repetitions occurred
the higher the chance of getting the HD.
The symptoms of HD are usually noticeable
around age 30s to 40s. In the early stage, patients might see some changes in
mood, movement and behavior but they are still able to do daily activity like
driving. In the mid to late stages, patients could experience involuntary movement
(Tremors), aggression, difficulty swallowing, depression, speech impairment, memory
lose and many other symptoms.
Currently, HD is not yet curable
but patients are given medications to help reduce the symptoms and make them
comfortable as possible. One of the article I read online says that Huntington
diseases patients who are doing physical therapy has maintained a reasonably
good level of motor performance and cognitive level than it would have been without
therapy. However, the article didn’t mention how long/often the patients received
therapy and what stage of the disease they were on. In your opinion would the
effect of physical therapy be differ in the early and later stage of HD? How often
would you recommend the therapy to the patients?
http://www.hdsa.org/living-with-huntingtons/family-care/stages-of-hd.html
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001775/
http://en.wikipedia.org/wiki/Huntington%27s_disease
I read an article from Standford University and they, too supported that physical therapy has the potential to improve the quality of life for patients with HD. I think that such a treatment would be good for those with this disease, but that the stage of progression that each patient has would definitely determine the efficacy of said treatment. Like you said in early stages, patients are still able to do most every day activities and I think it is at this stage that physical therapy would be most effective. Patients would be able to fine-tune their abilities and their treatment to specifically target those activities that are currently giving them a struggle, while strengthening all other ones. In mid to late stage HD however, I don't think physical therapy would be as effective. I think it would be hard to have a degenerative brain relearn the skills it has recently lost, though I do think progression may slow down. Either way, treatment would need to be administered quite frequently, perhaps multiple times per week, so that the brain would not have time to degenerate between sessions.
ReplyDeletehttps://www.stanford.edu/group/hopes/cgi-bin/wordpress/2010/06/physical-therapy-and-huntingtons-disease-treatment-and-management/
http://www.hdsa.org/living-with-huntingtons/family-care/stages-of-hd.html
By the time most individuals reach the age of 30-40, they tend to be less active. It seems like adding in physical therapy could help with just that change in how active people are (providing some similar benefits to exercise). As far as cognitive abilities, many people in this age range spend most of their days sitting at a desk doing the same thing they do everyday, and would therefore not get much of a chance to exercise their brains as well as bodies. Younger people are probably making more neural connections than older people since they are less experienced and tend to learn new things more often. Physical therapy can be modified for the individual patient to suit their needs, but exercising in general may help too (it usually helps with just about everything). I wonder if there have been studies done showing a correlation with certain lifestyles and HD. I think that would be interesting, but probably difficult to test.
ReplyDeleteI agree with what Jana said, as people get older they tend to get less active so it’s hard for them to involve in physical therapy. But as there is no medication for the Huntington Disease, symptom management would be the goal of treatment.
ReplyDeleteIf physical therapy can help the symptom, then why not? Depending on patient situation/condition, we can provide them the exercise they can do which will help them to build strength. And as we all know exercise can also help fight depression.
I really don't feel like someone in their thirties or forties would have an immensely difficult time engaging in therapy. Typically, someone goes to therapy because they want to be there and want to help themselves get better. I don't think that it's a matter of how hard it is for them to engage in the physical activities, but more so a matter of the therapist adjusting the different levels of the patients. The same routine may be similar amongst the HD patients, but it's highly unlikely that they will be ABSOLUTELY identical.
ReplyDeleteTypically, the earlier you try to treat the symptoms the better. Once the individual discovers that they have HD, I'd think that they should go ahead and get started on some sort of PT routine, and keep up with the exercises daily. Like I'm sure more people are aware of, it's good to exercise the mind as well as the body. The more you use your muscles, the stronger they get. The every day usage should help decrease the appearance of HD symptoms, if not at least aid the patient is some other beneficial way.
The biggest problem I've heard of is people complaining that they have no time to do their exercises... That is the most over used excuse. Everyone has five minutes here to do one exercise, and another five minutes there to do another. It's just a matter of how determined the individual is to try and stay with the routine.