Comparison of two exergame-based motor-cognitive trainings: protocol for a pilot study on cognitive, motor, and psychiatric symptoms in patients with Huntington’s disease (CARE-MH)

Background: Huntington’s disease (HD) is a rare, hereditary neurodegenerative disorder. Symptoms manifest around the age of 40 and encompass a range of physical, cognitive, and psychiatric impairments. Motor and cognitive exercises have been shown to slow the progression of symptoms. Particular attention has been given to motor-cognitive training, which may combine the benefits and contribute to delaying the progression of the disease. However, studies investigating the efficacy of such training in HD remain limited. At the same time, the use of exergaming has shown promise in improving participant engagement in training, which may in turn enhance both physical and cognitive functioning. The aim of our pilot study is to evaluate the feasibility and effects of two home-based motor-cognitive trainings via an exergame on motor, cognitive, and psychiatric symptomatology in HD patients. Methods: Patients, from stages 1 and 2, will be randomly assigned to one of the two groups: sequential exercises (separate motor and cognitive exercises) or synergical exercises (simultaneous motor and cognitive exercises). Training sessions will be conducted individually over a 12-week period (3 sessions/week ; 60 minutes/session). Linear mixed-effects models will be used to assess training’s effects on balance, walking capacity, lower-extremity strength, disease-related motor impairments, global cognition, executive functions, depression, anxiety, disease-specific psychiatric symptoms, and quality of life. Discussion: Our pilot study will be the first one to compare two exergame-based motor-cognitive trainings in HD patients. It is expected to be feasible, with improvements in motor, cognitive, and psychiatric symptoms in both groups. However, greater improvements are expected in the synergical group compared to the sequential group.