Huntington’s Disease & Specialist Seating

 

What is Huntington’s Disease?

 

Huntington’s disease is a rare neurodegenerative disorder of the central nervous system that stops parts of the brain working properly1.

 

Huntington’s disease is an inherited condition; both men and women can develop the disease. It is caused by a faulty gene that results in parts of the brain becoming gradually damaged over time, and can affect an individual’s movement, cognitive function and behaviour2.

 

How Can Huntington’s Disease Challenge Seated Posture?

 

  • Chorea (involuntary movements) can impair postural control and pelvic stability
  • Pelvic instability can result in posterior pelvic tilt and/or rotation and excessive thoracic kyphosis
  • The resulting reduced sitting ability can increase the risk of sliding down the chair
  • Dystonia (uncontrollable muscle spasms) can cause pain and affect range of movement
  • Fatigue can significantly impact on function and independence
  • Repetitive and energetic choreic movements can result in weight loss
  • In the later stages of the disease individuals can adopt more massed flexion posturing

 

Are There Any Seating Solutions That Can Support These Postural Challenges?

 

With individuals living with Huntington’s disease leading a largely sedentary lifestyle, specialist seating that promotes comfort and stability, and maintains seatability, is essential.

 

  • A chair measured for the user with correct seat dimensions is vital for pelvic stability and postural control, subsequently encouraging normal movement/managing abnormal movements.
  • A ramped or angled base, graduated at the back, will position the pelvis lower than the knees to promote safety and security for the individual by reducing the risk of sliding out of the chair.
  • Where necessary, and following a risk assessment, a pelvic belt or groin harness can further encourage pelvic stability. Least restrictive positioning methods should be trialled first.
  • Postural support at all body segments can encourage them to work together efficiently.
  • Trunk and head support is imperative for functional ability, including safe eating and drinking to reduce the risk of aspiration or choking.
  • Tilt-in-space, if appropriate, can help individuals to manage available energy levels and promote rest by reducing the effects of gravity for a period of time; they can then conserve energy to direct it into activities of daily living important to them.
  • Tilt-in-space can also support pelvic stability, postural control and pressure redistribution without compromising the hip angles when tilted slightly posteriorly.
  • Pressure care is a crucial consideration as bony prominences from weight loss become at risk from striking the chair during choreic movements. There are also skin integrity risks from prolonged sitting, unequal weight distribution and shearing forces from sliding forward.

 

Choosing the right chair can provide individuals with a place of safety and security, whilst reducing the risk of secondary complications.

 

How Can CareFlex Help?

 

The HydroTilt can offer individuals with Huntington’s disease essential postural management and pressure care whilst promoting comfort and relaxation. Available in mini, small, medium and large size, and also modular in design, ensures that it can be easily tailored to the individual. Adjustability throughout the chair will enable the appropriate chair dimensions to be achieved, promoting pelvic stability and postural control.

Postural support at all body segments will encourage functional ability and energy management. Tilt-in-space, if appropriate, can crucially reduce the risk of the user sliding out of the chair and provide periods of rest. A seat wedge can further stabilise the user’s pelvis at the back of the chair.

 

Activities of daily living, such as interaction and safe mealtimes, will be supported by a range of lateral trunk and head supports. A contoured back can promote trunk alignment, or a waterfall back can manage an increased thoracic kyphosis; a tray can also be added for anterior upper limb support. A negative angle leg rest can also facilitate standing transfers and accommodate tight hamstrings muscles and knee contractures.

 

The robust frame is designed to withstand involuntary movements and unstable sitting transfers. Padded elements, including the armrest and footplate, throughout the chair can also protect the user from injury during these uncontrolled choreic movements.

 

WaterCell Technology® is at the heart of CareFlex specialist seating. The effectiveness of our WaterCell Technology has undergone independent testing and evaluation, including pressure mapping and published clinical research, which can be accessed via our website.

WaterCell Technology provides a reliable and dynamic pressure redistributing solution. It enables the user to achieve a stable and functional posture without compromising on pressure management and comfort. In a managed and trained health or care environment, WaterCell Technology will suit users of all risk categories when used as part of a holistic posture and pressure management programme.

 

A regular change of position is a key part of 24-hour posture management and pressure care.  As Huntington’s disease is a progressive disease, reviews will be critical.

 

Please do not hesitate to get in touch

 

References:

 

  1. NHS Choices (2018) Huntington’s disease Available from: nhs.uk/conditions/huntingtons-disease/
  2. Huntington’s Disease Association (2018) Symptoms of Huntington’s disease Available from: hda.org.uk/huntingtons-disease/what-is-huntingtons-disease/symptoms-of-huntingtons-disease