# Exercise as it relates to Disease/Exercise and it effects on the symptoms of Huntingtons's disease
### What is Huntington's Disease?

Huntington's disease (HD) is a neurodegenerative genetic disorder causing the death of brain cells in certain areas of the brain. Resulting in gradual loss of cognitive, physical and emotional function. This impacts the individuals ability to participate freely in the community dependent on what stage of HD they are currently in.

### Symptoms

Symptoms can begin to appear when the person is in their thirties or forties. they may include
* Random, jerky, Uncontrollable movement (Chorea)
* Mild twitching of the fingers and toes
* Lack of coordination and a tendency to knock things over
* Walking difficulties
* Speech and swallowing difficulties.
* Short-term memory loss
* Difficulties in concentrating and making plans.
* Mood swings, apathy and aggression.

## Exercise and Huntingtons Disease

Many different studies have looked at the effects of varying exercise interventions for Huntington's Disease. Most look at Physical therapy or some kind of rehabilitation program. As exercise has been shown to at least maintain or even improve brain health/volume in healthy demographics, research results have varied between studies, because HD can vary so much between people and again as to what stage they are at. As HD is not something that can be cured at the moment, the main goal for a lot of programs is to help manage and minimise the impact of the disease on their everyday life and allow them to participate in the community. Although studies have shown improvement in individuals, it is accepted that further research is required to see if these improvements are maintained or if continual therapy/exercise is required.

## Recommendations

As HD can vary between individual, consideration of such factors as stage of HD and motivation of the individual to participate need to be taken into account. For those mild to moderately affected by HD, a home exercise regime focused on balance, co-ordination and flexibility can help manage the symptoms of HD. As for those with mid to late stage HD further research is required into possible intervention.

## Further reading

* Huntingtons Victoria, http://www.huntingtonsvic.org.au/
* Medical News Today, http://www.medicalnewstoday.com/articles/159552.php
* http://www.medicinenet.com/huntington_disease/article.htm

## References

1. Zinzi, Paola, et al. "Effects of an intensive rehabilitation programme on patients with Huntington's disease: a pilot study." Clinical rehabilitation 21.7 (2007): 603-613.
2. Quinn, Lori, et al. "Client and therapist views on exercise programmes for early-mid stage Parkinson's disease and Huntington's disease." Disability & Rehabilitation 32.11 (2010): 917-928.
3. Bilney, Belinda, Meg E. Morris, and Alison Perry. "Effectiveness of physiotherapy, occupational therapy, and speech pathology for people with Huntington's disease: a systematic review." Neurorehabilitation and neural repair 17.1 (2003): 12-24.
4. Busse, M. E., and A. E. Rosser. "Can directed activity improve mobility in Huntington's disease?." Brain research bulletin 72.2 (2007): 172-174.
5. Hausdorff, Jeffrey M., et al. "Altered fractal dynamics of gait: reduced stride-interval correlations with aging and Huntington’s disease." Journal of applied physiology 82.1 (1997): 262-269.
6. Busse, Monica E., et al. "Physical therapy intervention for people with Huntington disease." Physical therapy 88.7 (2008): 820-831.
7. Khalil, Hanan, et al. “What effect does a structured home-based exercise programme have on people with Huntington's disease? A randomized, controlled pilot study.” Clinical Rehabilitation 27.7 (2013): 646-658
8. Kloos, Anne D., et al. “video game play (dance dance revolution) as a potential exercise therapy in Huntington's disease: a controlled clinical trial” Clinical Rehabilitation 27.11 (2013): 972-982
9. Pang, T. Y. C., et al. "Differential effects of voluntary physical exercise on behavioral and brain-derived neurotrophic factor expression deficits in Huntington’s disease transgenic mice." Neuroscience 141.2 (2006): 569-584.
10. Hillman, Charles H., Kirk I. Erickson, and Arthur F. Kramer. "Be smart, exercise your heart: exercise effects on brain and cognition." Nature Reviews Neuroscience 9.1 (2008): 58-65.
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12. Colcombe, Stanley J., et al. "Aerobic exercise training increases brain volume in aging humans." The Journals of Gerontology Series A: Biological Sciences and Medical Sciences 61.11 (2006): 1166-1170.