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Rehabilitation Therapy Interventions for the HD Patient

Proper shoe fitting and recommendations

We can recommend the type of shoe or sneaker that would best accommodate the variety of walking problems that are related to HD. Orthotics or shoe inserts may be recommended to maintain proper foot and ankle positioning if this is problem.

Assistive devices

Positioning devices and aids

a. Walking stick;

b. Foot positioning device for wheelchair;

c. wedge cushion for wheelchair positioning;

d. Insole for foot support

Positioning devices and aids

Canes or walkers can be useful to help keep people with HD walking for a longer amount of time. Most importantly, assistive devices can prevent falls, which often can lead to fractures or worse. Specialized 4-wheeled walkers have been very useful for many people with HD. They have small seats (to use if you get tired), a basket to carry personal items, can move over a variety of terrain, and can help individuals maintain a natural walking pattern. See article

Adaptive equipment

A variety of adaptive equipment is available to assist with eating, bathing, dressing and various daily life skills. We recently purchased many commonly used adaptive devices so that patients who come to the HD clinic can try the equipment before they go out and purchase it.

Adapted equipment for feeding 1

a. weighted spoons, forks and knife prescribed for individuals with weakness in hand muscles and chorea;

b. weighted cup with lid for individuals with muscle weakness and incoordination to prevent spillage;

c. scoop plate and dysum mat for individuals with muscle weakness and incoordination and to revent spillage.

Adapted equipment for feeding

Adapted equipment for feeding 2

a. Foam tubing to build up handles for better grip;

b. Water bottle with lid and spout for regulating amount of fluid intake;

c. Wrist weight for individuals with mild chorea;

d. Utensil with suction cup to provide stability for individuals with incoordination;

e. Dysum sheet;

f. Thera-putty for exercising hand muscles;

g. Travel mug with lid;

h. Therapeutic weights with strap

Adaptive equipment for feeding

Wheelchair recommendations

Wheelchairs can be beneficial for occassional use for long distance mobility (to go shopping, or to the airport), or for daily use, when walking is no longer a feasible option. We can make wheelchair recommendations at the HD Clinic, or we can refer you to the specialized Wheelchair Clinic at New York-Presbyterian Hospital.

Exercise programs

Exercise is one of the most important ways that many people with HD feel they are able to fight off the effects of the disease process. We can recommend a variety of exercise programs to meet any individual's specific needs. We also can make referrals to physical therapists in the New York City Metropolitan area so that you can receive more intensive physical therapy near or in your home if necessary.

Although not universally recognized as a therapeutic option, we have included a message from a family member whose brother first rode horseback at HD Camp and now rides each week at a nearby therapeutic stable. See Horseback-Riding.

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Columbia University Medical Center : Department of Neurology : Last updated 27-Jun-2009