The purpose of this article is to provide a brief review of the principles of motor control and learning. Different models of motor control from historical to contemporary are presented with emphasis on the Systems model. Concepts of motor learning including skill acquisition, measurement of learning, and methods to promote skill acquisition by examining the many facets of practice scheduling and use of feedback are provided. A fictional client case is introduced and threaded throughout the article to facilitate understanding of these concepts and how they can be applied to clinical practice.

The aim of this study was to explore feasibility, safety and outcome of an exercise intervention in people with Huntington’s disease. A randomized controlled pilot trial. A home-based exercise programme. A total of 25 subjects with early to mid-stage Huntington’s disease. Subjects were randomly allocated to either an exercise intervention (n = 13) or a control group (n = 12). Subjects in the exercise intervention group were asked to perform exercises at home three times a week for eight weeks using an exercise DVD, specifically developed for this purpose. The control group received their usual care. Adherence in the intervention group was calculated from exercise diaries. Measures of gait, balance, function, level of physical activity and quality of life were evaluated. Analysis of covariance was used to compare follow-up scores across groups after adjustment for chance baseline differences. Effect sizes were calculated. Eleven participants from the intervention and ten from the control group completed the study. Mean adherence was 29.4 SD 1.8 for the 32 prescribed sessions. There were no related adverse events. Differences between groups were observed in gait speed, balance, function and level of physical activity, but not quality of life as measured by the SF36. Effect sizes were large (>0.8) for the majority of the outcomes. Short-term structured home exercise programmes are feasible, beneficial and safe for people with early to mid-stage of Huntington’s disease. Our findings support the implementation of a larger trial of longer-term home exercise.

Background: A number of studies evaluating physical therapy and exercise interventions in Huntington’s disease have been conducted over the past 15 years. However, an assessment of the quality and strength of the evidence in support of these interven

The present study examined the coordination of prehensile forces during precision grip in subjects with Huntington's disease (HD). Fingertip forces were measured in 12 subjects with HD and 12 age-matched controls during the lifting of an instrumented object whose weight and surface texture were varied. The results indicate that subjects with HD have impaired initiation and delayed transitions between movement sequences and produce excessive and variable forces. However, subjects with HD demonstrated anticipatory scaling of force development based on the object's expected physical properties (planning) and adjustment of the force to the object's actual physical properties (sensorimotor integration). The observed findings generally were unrelated to the overall disease severity. However, the variability in forces was correlated with functional capacity and motor performance suggesting that variability is a key feature of the motor deficit. These results provide insights into the impaired hand function observed in individuals with HD.

The beneficial role of exercise as a treatment approach in Huntington's disease (HD) has support from both preclinical work and small-scale studies; however, there have been no controlled studies of gym-based exercise in people with HD. This phase 2 randomized trial (ISRCTN 59910670) assessed feasibility, safety, acceptability, and benefit of a structured exercise program. Thirty-one participants (16 men; mean [SD] age = 50.4 [11.4] years) were randomly allocated to intervention (n = 16) or control group (usual care; n = 15). The intervention entailed a weekly supervised gym session of stationary cycling and resistance exercises, and a twice weekly independent home-based walking program. Retention and adherence rates and adverse events were recorded. Acceptability was determined from subjective reports of tolerability and physiological measures recorded during the gym sessions. Assessment of benefit included measures of physical abilities, disease severity, and quality of life (36-Item Short Form Health Survey). Analysis of covariance was used to test outcomes of interest. The retention rate was 81% (9 of the 11 individuals who started the intervention completed it) and of the 9 who completed the program, 7 attended more than 75% (9/12) of the gym sessions. There were no related adverse events and the intervention was well tolerated by most participants. The between-group effect estimate for the Mental Component Summary score of the 36-Item Short Form Health Survey (n = 9; intervention, n = 13; control) was 7 (95% CI: 0.4-13.7) Moderate effect sizes for cognitive outcomes and measures of walking were also observed. Observed effect sizes for clinical outcomes suggest the structured exercise program has benefit for persons with HD; larger scale trials are warranted.Video Abstract available (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A60) for more insights from the authors.