Huntington's Disease
Conditions
Keywords
Huntington's Disease, gait, exercise, balance, video game
Brief summary
To examine the benefits of using a video-game, Dance, Dance, Revolution, as an exercise modality to improve gait and balance in individuals with Huntington's disease.
Detailed description
The primary purpose of this study was to determine the effectiveness of a therapist-guided Video-game Biofeedback Modulated Exercise (ViBE) program administered via Dance Dance Revolution to improve dynamic balance, gait and mobility in individuals with Huntington's Disease. Secondary aims were to explore whether the ViBE intervention would improve quality of life, fall risk, and neuropsychological functions. The investigators hypothesized that the video-game program would lead to greater improvements in walking, dynamic balance, quality of life, fall risk, and neuropsychological function than a control handheld video game program. Since motivation is essential to the long-term maintenance of an exercise program the investigators were also interested in finding out how successful people with Huntington's Disease were at playing Dance Dance Revolution, what their perceptions were of playing the game, and whether they thought that it was beneficial
Interventions
OTHERVideo game exercise using Dance Dance Revolution
use of the video-game, Dance, Dance Revolution as an exercise to improve gait and balance
OTHERhand-held video game
hand-held video games
Sponsors
Anne Kloos
Study design
Allocation
NON_RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Investigator)
Intervention model description
Participants completed one arm of the study and then crossed over into the other arm of the study
Eligibility
Sex/Gender
ALL
Age
18 Years to 79 Years
Healthy volunteers
No
Inclusion criteria
* adults 18 - 79 with a diagnosis of Huntington's disease
Exclusion criteria
* cannot walk 10 feet without assistance, any other neurologic condition
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Gait Parameters | 6 weeks | utilized GAITRite to obtain spatiotemporal measures of gait: forward velocity. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Tinetti Mobility Test | 6 weeks | Observation of gait and balance with quantifiable 16-item assessment with an ordinal scale of 0-2 for up to a total score of 32, with higher scores indicating better performance. It is reliable and predicts falls among those with Parkinson's disease and Huntington's disease. |
| Four Square Step Test | 6 weeks | Examines ability to step over an object in multiple directions and is timed. Participants are instructed to step over a cane into each square in a specific order. Faster times indicate better balance. It has been shown to predict falls in the elderly. |
| Activities-Specific Balance Confidence Scale | 6 weeks | Individuals rate their balance confidence from 1-100 on 16 tasks and total score is the mean; higher scores indicate greater confidence and lower fall risk. The Activities-Specific Balance Confidence Scale is reliable and valid in elderly and neurological populations. |
| World Health Organization Quality of Life | post intervention and post hand-held game, each lasts 6 weeks | This questionnaire is a measure of quality of life addressing 4 domains including physical, psychological, social, and environment health. Responses on 26 items are on a five-point scale (from 1 = very dissatisfied to 5 = very satisfied) and each item is added to achieve a total score for each domain. The mean score for each domain is calculated then multiplied by 4 to get the domain score which are then transformed to a scaled score of 0-100 comparable to the original WHOQOL-100 therefore a total score between 0-400 with high scores indicating better quality of life. The WHOQOLBref has good reliability and validity. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Dance Dance Revolution Exercise, Then Hand Held Video Game (Control) Participants first completed the video game exercise using Dance Dance Revolution: use of the video-game, Dance, Dance Revolution as an exercise to improve gait and balance. Then participated in a hand held video game as the control activity. | 13 |
| Hand Held Video Game (Control), Then Dance Dance Revolution Exercise Individuals first participated in the control group: a hand-held video game. Then completed the video game exercise using Dance Dance Revolution: use of the video-game, Dance, Dance Revolution as an exercise to improve gait and balance. | 11 |
| Total | 24 |
Baseline characteristics
| Characteristic | Dance Dance Revolution Exercise, Then Hand Held Video Game (Control) | Hand Held Video Game (Control), Then Dance Dance Revolution Exercise | Total |
|---|---|---|---|
| Age, Continuous | 52.9 years STANDARD_DEVIATION 13 | 50 years STANDARD_DEVIATION 16.4 | 51.6 years STANDARD_DEVIATION 14.3 |
| Sex: Female, Male Female | 9 Participants | 6 Participants | 15 Participants |
| Sex: Female, Male Male | 4 Participants | 5 Participants | 9 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 24 | 0 / 18 |
| other Total, other adverse events | 0 / 24 | 0 / 18 |
| serious Total, serious adverse events | 0 / 24 | 0 / 18 |
Outcome results
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: obstacle velocity.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 1.16 meters per second | Standard Deviation 0.49 |
| Hand Held Video Game (Control) | Gait Parameters | 1.14 meters per second | Standard Deviation 0.43 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: backwards swing percent.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 37.24 percentage of gait cycle spent in swing | Standard Deviation 4.05 |
| Hand Held Video Game (Control) | Gait Parameters | 35.83 percentage of gait cycle spent in swing | Standard Deviation 4.37 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: backwards double support percent.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 26.43 percent of gait cycle in double support | Standard Deviation 10.54 |
| Hand Held Video Game (Control) | Gait Parameters | 30.71 percent of gait cycle in double support | Standard Deviation 9.44 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: backwards heel to heel base of support.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 20.61 cm | Standard Deviation 5.71 |
| Hand Held Video Game (Control) | Gait Parameters | 21.28 cm | Standard Deviation 5.41 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: backwards velocity.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 0.81 meters per second | Standard Deviation 0.41 |
| Hand Held Video Game (Control) | Gait Parameters | 0.83 meters per second | Standard Deviation 0.42 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: forward velocity.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 1.289 meters per second | Standard Deviation 0.47 |
| Hand Held Video Game (Control) | Gait Parameters | 1.292 meters per second | Standard Deviation 0.47 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: forward stride length.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 123.35 cm | Standard Deviation 35.23 |
| Hand Held Video Game (Control) | Gait Parameters | 123.11 cm | Standard Deviation 35.9 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: forward swing percent.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 36.82 percentage of gait cycle spent in swing | Standard Deviation 3.64 |
| Hand Held Video Game (Control) | Gait Parameters | 36.01 percentage of gait cycle spent in swing | Standard Deviation 4.33 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: forward double support percent.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 25.83 percent of gait cycle in double support | Standard Deviation 7.36 |
| Hand Held Video Game (Control) | Gait Parameters | 28.34 percent of gait cycle in double support | Standard Deviation 8 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: forward heel to heel base of support.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 12.37 cm | Standard Deviation 5.14 |
| Hand Held Video Game (Control) | Gait Parameters | 12.69 cm | Standard Deviation 5.41 |
Primary
Gait Parameters
utilized GAITRite to obtain spatiotemporal measures of gait: backwards stride length.
Time frame: 6 weeks
Population: GAITRite outcome data was eliminated for one participant who consistently exhibited an abnormal gait during testing sessions on the walkway that did not reflect his usual walking pattern. One participant could not walk backward. Thus, 17 participants were included in the GAITRite analysis (n = 16 for backward condition).
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Gait Parameters | 81.09 cm | Standard Deviation 31.78 |
| Hand Held Video Game (Control) | Gait Parameters | 83.44 cm | Standard Deviation 32.6 |
Secondary
Activities-Specific Balance Confidence Scale
Individuals rate their balance confidence from 1-100 on 16 tasks and total score is the mean; higher scores indicate greater confidence and lower fall risk. The Activities-Specific Balance Confidence Scale is reliable and valid in elderly and neurological populations.
Time frame: 6 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Activities-Specific Balance Confidence Scale | 78.40 score on a scale | Standard Deviation 15.64 |
| Hand Held Video Game (Control) | Activities-Specific Balance Confidence Scale | 77.56 score on a scale | Standard Deviation 15.24 |
Secondary
Four Square Step Test
Examines ability to step over an object in multiple directions and is timed. Participants are instructed to step over a cane into each square in a specific order. Faster times indicate better balance. It has been shown to predict falls in the elderly.
Time frame: 6 weeks
Population: Loss of one participant in Four-Square Step Test due to incomplete data
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Four Square Step Test | 10.19 seconds | Standard Deviation 3.77 |
| Hand Held Video Game (Control) | Four Square Step Test | 10.02 seconds | Standard Deviation 7.81 |
Secondary
Tinetti Mobility Test
Observation of gait and balance with quantifiable 16-item assessment with an ordinal scale of 0-2 for up to a total score of 32, with higher scores indicating better performance. It is reliable and predicts falls among those with Parkinson's disease and Huntington's disease.
Time frame: 6 weeks
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | Tinetti Mobility Test | 22.94 score on a scale | Standard Deviation 4.23 |
| Hand Held Video Game (Control) | Tinetti Mobility Test | 22.61 score on a scale | Standard Deviation 3.29 |
Secondary
World Health Organization Quality of Life
This questionnaire is a measure of quality of life addressing 4 domains including physical, psychological, social, and environment health. Responses on 26 items are on a five-point scale (from 1 = very dissatisfied to 5 = very satisfied) and each item is added to achieve a total score for each domain. The mean score for each domain is calculated then multiplied by 4 to get the domain score which are then transformed to a scaled score of 0-100 comparable to the original WHOQOL-100 therefore a total score between 0-400 with high scores indicating better quality of life. The WHOQOLBref has good reliability and validity.
Time frame: post intervention and post hand-held game, each lasts 6 weeks
Population: Loss of one participant for the WHOQOL-Bref due to incomplete data
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Dance Dance Revolution Exercise | World Health Organization Quality of Life | 286 score on a scale | Standard Deviation 67.96 |
| Hand Held Video Game (Control) | World Health Organization Quality of Life | 294 score on a scale | Standard Deviation 58.96 |