Use of Objective Outcomes Measures to Verify the Effects of ICF-Based Gait Treatment in Huntington's Disease Patient on Globus Pallidus Deep Brain Stimulation: A Case Report.
Tamine T C Capato, Rubens G Cury, Juliana Tornai and 5 others
PMID 36189041WHAT IT FOUND
An advanced Huntington's disease patient improved in walking and balance after globus pallidus deep brain stimulation plus frequent ICF-based physiotherapy.
Because surgery, medication changes, and therapy all occurred, the contribution of each component cannot be separated.
Key findings
01Immediately after GPi DBS, chorea improved and olanzapine dose decreased to 2.5 mg, while depression and apathy did not significantly change.
02The patient received four 60-minute physiotherapy sessions per week for 18 months.
03At 6 months, TUG, BBS, and FIM showed more pronounced balance and gait improvements, and UHDRS scored 38 points; Mini-BESTest and retropulsion did not show significant effects.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a case report, so it cannot show what would happen in other patients. GPi DBS, medication dose changes, and physiotherapy all occurred, so the contribution of each component cannot be separated. The patient had advanced Huntington's disease and was dependent on a caregiver, so the report may not apply to earlier stages. Some outcome measures did not show significant effects, including Mini-BESTest and retropulsion test. The authors state that formal speech therapist, occupational therapist, social worker, nurse specialist, and psychologist assessments were not included. Follow-up was 18 months, and the authors note slight deterioration over that period.
The easy way to misread this
Do not conclude that ICF-based physiotherapy alone improved this patient's gait. The patient also had GPi DBS and medication dose changes, and this is a case report, so the contribution of each component cannot be separated.