Deficits in stepping response time are associated with impairments in balance and mobility in people with Huntington disease

Goldberg, Allon; Schepens, Stacey L.; Feely, Shawna M.E.; Garbern, James Y.; Miller, Lindsey J.; Siskind, Carly E.; Conti, Gerry E.

doi:10.1016/j.jns.2010.08.002

« Previous Next »Journal of the Neurological Sciences
Volume 298, Issue 1 , Pages 91-95, 15 November 2010

Deficits in stepping response time are associated with impairments in balance and mobility in people with Huntington disease

Allon Goldberg
- Department of Health Care Sciences, Program in Physical Therapy, Mobility Research Laboratory, Wayne State University, 259 Mack Ave., Detroit, MI 48201, USA
- Institute of Gerontology, Wayne State University, 87 East Ferry St., Detroit, MI 48202, USA
- Department of Internal Medicine, School of Medicine, Wayne State University, 3800 Woodward Ave., Detroit, MI 48201, USA
- Corresponding author. Department of Health Care Sciences, Program in Physical Therapy, Mobility Research Laboratory, Wayne State University, 259 Mack Ave., Detroit, MI 48201, USA. Tel.: +1 313 577 8608; fax: +1 313 577 8685.
Stacey L. Schepens
- Department of Health Care Sciences, Program in Physical Therapy, Mobility Research Laboratory, Wayne State University, 259 Mack Ave., Detroit, MI 48201, USA
- Institute of Gerontology, Wayne State University, 87 East Ferry St., Detroit, MI 48202, USA
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI 48109, USA.
Shawna M.E. Feely
- Department of Neurology and Center for Molecular Medicine and Genetics, School of Medicine, Wayne State University, 421 E. Canfield Rd, Detroit, MI 48201, USA
James Y. Garbern
- Department of Neurology and Center for Molecular Medicine and Genetics, School of Medicine, Wayne State University, 421 E. Canfield Rd, Detroit, MI 48201, USA
Lindsey J. Miller
- Department of Neurology and Center for Molecular Medicine and Genetics, School of Medicine, Wayne State University, 421 E. Canfield Rd, Detroit, MI 48201, USA
Carly E. Siskind
- Department of Neurology and Center for Molecular Medicine and Genetics, School of Medicine, Wayne State University, 421 E. Canfield Rd, Detroit, MI 48201, USA
Gerry E. Conti
- Department of Health Care Sciences, Program in Occupational Therapy, Human Movement Laboratory, Wayne State University, 259 Mack Ave., Detroit, MI 48201, USA

Received 2 June 2010; received in revised form 29 July 2010; accepted 5 August 2010. published online 01 September 2010.

Abstract

Huntington disease (HD) is a disorder characterized by chorea, dystonia, bradykinesia, cognitive decline and psychiatric comorbidities. Balance and gait impairments, as well as falls, are common manifestations of the disease. The importance of compensatory rapid stepping to maintain equilibrium in older adults is established, yet little is known of the role of stepping response times (SRTs) in balance control in people with HD. SRTs and commonly-used clinical measures of balance and mobility were evaluated in fourteen symptomatic participants with HD, and nine controls at a university mobility research laboratory. Relative and absolute reliability, as well as minimal detectable change in SRT were quantified in the HD participants. HD participants exhibited slower SRTs and poorer dynamic balance, mobility and motor performance than controls. HD participants also reported lower balance confidence than controls. Deficits in SRT were associated with low balance confidence and impairments on clinical measures of balance, mobility, and motor performance in HD participants. Measures of relative and absolute reliability indicate that SRT is reliable and reproducible across trials in people with HD. A moderately low percent minimal detectable change suggests that SRT appears sensitive to detecting real change in people with HD. SRT is impaired in people with HD and may be a valid and objective marker of disease progression.

Keywords: Stepping response time, Balance, Mobility, Huntington disease