Upper Extremity Motor Performance During a Shirt Buttoning Task in Huntington’s Disease

Abstract

Background: Motor impairment in Huntington’s Disease (HD) includes chorea, bradykinesia, dystonia, and rigidity, causing Upper extremity (UE) impairments in daily activities. Objectives: Describe motor patterns and analyze execution times for buttoning a shirt in premanifest and manifest-HD versus controls; explore the relationship between clinical assessments and UE motor performance and assess interobserver reliability of the motor pattern coding system. Methods: Cross-sectional observational study with 30 manifest-HD, 9 premanifest-HD, and 30 controls from Burgos University Hospital, Spain. Participants buttoned a five-button shirt and time spent and motor patterns were analyzed using Observer-XT-software. Results: Significant differences were found in movement time and motor patterns between groups. Manifest-HD took nearly twice as long as controls to complete the task. Correlations were found with clinical assessments. Degree of interobserver agreement was excellent. Conclusion: Evaluating motor patterns helps in early detection of motor impairment, monitoring disease progression, and developing rehabilitation programs to maintain and improve UE function Plain Language Summary: How Huntington’s Disease affects upper limb movements and impact on quality of life, motor, cognitive, and psychiatric symptoms when buttoning a shirt The research aims to explore motor patterns and execution times during buttoning a shirt in people with Huntington’s Disease (HD) at different stages (premanifest-HD and manifest-HD) compared to controls. Premanifest-HD is the stage before noticeable symptoms appear, while manifest-HD is when symptoms become noticeable (involuntary movements, difficulty with coordination, changes in thinking . . .). The disease progresses over time, and symptoms become more severe. The primary research question is: How do motor patterns and execution times differ between individuals with HD (premanifest and manifest) and controls? The hypothesis is that individuals with manifest-HD will exhibit significantly impaired motor patterns and longer execution times compared to controls. The study hopes to uncover early indicators of motor decline and provide insights for developing targeted rehabilitation programs. This research is crucial because motor impairments in HD, such as chorea, bradykinesia, dystonia, and rigidity, significantly impact the quality of life and independence of individuals. HD is a progressive neurodegenerative disorder, and understanding these impairments can lead to better management and treatment strategies. HD affects approximately 5–10 per 100,000 people worldwide. This research impacts not only individuals with HD but also their families, caregivers, and health care systems. The study employed an observational cross-sectional design, ideal for comparing different groups at a single point in time. It provides a snapshot of the differences in motor function between individuals with manifest-HD, premanifest-HD, and healthy controls. Key variables included the time taken to button a five-button shirt and the motor patterns used during the task. Participants included 30 individuals with manifest-HD, 9 with premanifest-HD, and 30 healthy controls. The use of Observer-XT software ensured precise and objective measurement of the variables.