Multimodal balance training with rhythmical auditory cueing in Huntington's disease: A pilot randomized controlled trial

Background Balance impairments in Huntington's Disease (HD) are common but difficult to treat. Objectives We aimed to investigate the potential effects and feasibility of multimodal physiotherapy balance intervention in HD. Method In this prospective, double-blind, parallel group randomized clinical trial (phase 1pilot study), we screened 56 persons with genetically confirmed HD; 36 were assigned randomly into three groups: 1) multimodal physiotherapy balance intervention supported by rhythmical auditory stimuli (RAS-supported, n = 12); (2) multimodal physiotherapy balance intervention without rhythmical auditory stimuli (Regular, n = 12); and (3) control intervention (educational program, n = 12). Interventions were delivered for 2-months, at a low dose, 1 session/week. The primary outcome was the Mini-BESTest scored directly after the intervention. All outcomes were assessed at three time-points. Results Directly post-intervention, both the RAS-supported group and the Regular group improved significantly on the Mini-BESTest score compared to the Control group (RAS-supported 4.2 (95% Confidence Interval(CI) 3.1; 5.2), p < 0.001; Regular 2.7 (CI 1.7; 3.6), p < 0.001. These improvements were retained at 6-month follow-up only for the RAS-supported group. Conclusion These findings motivate future studies to further explore multimodal physiotherapy interventions to improve balance in HD.