Huntington's Disease with Gait and Balance Disorders: Addressing Falls and Loss of Independence
In Huntington's disease, the progressive complex movement disorder extends to motor control of walking and posture. A distinct clinical scenario arises when patients develop significant gait and balance impairments — creating substantial fall risk and threatening daily independence.
Clinical scenario
Patients present with disruption of cadence regulation, increased variability of step width and step length, disturbed gait initiation, and increased postural sway. These impairments contribute to falls and loss of independence, adding to the overall burden of motor morbidity in Huntington's disease.
Management approach — partial overview
The structured approach to this scenario centres on physiotherapy-led interventions including gait training, core stability, and balance programmes, alongside attentional strategies. The role of appropriate assistive devices is also addressed within the regimen.
The complete evidence-graded protocol — full intervention sequence, specific programme components, and assistive device guidance — is available via the link below.
References
DOI: 10.3389/fneur.2019.00710
- Gait and balance disorders impairments include disruption of cadence regulation, increased variability of step width and length, disturbed initiation and increased postural sway.
- These develop as a result of the progressive complex movement disorder seen in HD adding to the overall burden of motor morbidity with falls and loss of independence in HD.
- Physiotherapy interventions (Grade B) and the introduction of falls prevention programs, gait, core stability, and balance interventions (Grade C) as well as attentional training are recommended.
- The use of assistive devices such as four-wheeled walker (Grade B) as recommended by Physiotherapist or Occupational Therapist should be considered to improve stability and reduce fall risk.
- Maintaining physical activity and low impact exercises is recommended.
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