Tolerability and psychological effects of a multimodal day-care rehabilitation program for persons with Huntington's disease
Karin Ringqvist, Kristian Borg, Marika C. Möller
Department of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden. E-mail: firstname.lastname@example.org
Objective: To determine whether the psychological benefits of intense, inpatient, multimodal rehabilitation for persons with Huntingtons disease (HD), as found in earlier studies, also apply in a shorter, day-care setting.
Design: Prospective, non-randomized cohort study.
Subjects: Twenty patients attending a group-based 8-week (3 days/week) rehabilitation programme aimed at persons in early stages of HD.
Methods: An explorative cohort study on register data from a specialized rehabilitation centre, includ-ing descriptive data, number of cancellations, a self-reported evaluation, and measures of psychiatric symptoms, health-related quality of life, sense of coherence and physical function at baseline and at the end of rehabilitation.
Results: Patients' attendance rate was almost 90%. Patients were satisfied, and displayed significantly reduced anxiety and depression and improved health-related quality of life after rehabilitation. Baseline measures of sense of coherence showed significant negative correlation with the number of cancelled days of rehabilitation. Physical function improved, but did not correlate significantly with psychological outcome measures.
Conclusion: These results indicate that an 8-week multimodal day-care rehabilitation programme can be tolerable, reduce psychiatric symptoms, and improve health-related quality of life for people with HD. A higher sense of coherence seems to promote attendance rates. Further larger studies, including the impact of cognition and disease progression on the treatment effect, are warranted.
Huntington's disease (HD) is characterized by a triad of clinical features; motor, cognitive, and psychiatric. Physical training seems to have positive effects on motor symptoms. Earlier studies have shown that intense, inpatient, multimodal rehabilitation may also reduce psychiatric symptoms. The present study aimed to explore whether the psychological benefits are retained in a shorter, day-care setting.This study included 20 patients attending a group-based rehabilitation programme. The results show that participants had an almost 90 % attendance rate and were satisfied with the programme. After rehabilitation, they displayed significantly reduced anxiety and depression and improved quality of life. Sense of coherence showed a significant negative correlation with the number of cancelled days of rehabilitation. These results indicate that a shorter multimodal day-care rehabilitation programme can be easier to tolerate than longer programmes, and still reduce psychiatric symptoms and improve quality of life for people with HD. A higher sense of coherence appears to promote the attendance rate.
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