Tolerability and psychological effects of a multimodal day-care rehabilitation program for persons with Huntington's disease.

Only 20 patients completed the programme, and 2 of 22 enrolled patients dropped out, so the sample is small. There was no control group, so improvement could be due to time, natural fluctuation or other changes. Data were collected by the treating team, and examiners were not blinded. Self-rated questionnaires may be unreliable because Huntington's disease often affects awareness. The sample included adults able to take part in group activities and was aimed at early disease stages, so it may not apply to more advanced disease. 80% of the sample was female, although Huntington's disease affects men and women equally. The written evaluation was not validated. The programme included many treatments at once, so the effect of any one component cannot be separated. Physical measures were missing for some patients, and anxiety and depression analyses excluded one outlier. The study used years since diagnosis, not disease onset, and had no follow-up.

Do not conclude that this programme caused the improvements. It had no control group, only 20 patients completed it, and many treatments were delivered together, so the contribution of any single component cannot be separated.