Objective: To investigate whether behavioural, motor and physiological responses of individuals with Huntington's disease (HD) to a controlled multisensory environment (MSE) are effective as a therapeutic (sustained effects) or leisure (immediate effects) activity.
Design: Pilot study – a randomized, controlled, two-group design. Setting: Specialist residential unit for people with mid-late stage HD.
Subjects: Twelve patients with HD (one subject from each group dropped out during the study after week 8 due to medical complications).
Interventions: Patients attended eight, 30-minute sessions over a four-week period, of multisensory stimulation (MSE, treatment group) or relaxation activities (control group).
Main outcome measures: Between-group comparisons for changes between assessment sessions for two behavioural assessments: Rehabilitation Evaluation – Hall and Baker (REHAB), Behaviour and Mood Disturbance Scale (BMD); a motor assessment: the dyskinesia section of the St Hans Rating Scale (SHRS); physiological measures: blood pressure, heart rate and respiratory rate. Secondary measures during intervention sessions included behavioural assessment using the Interact.
Results: There were no significant differences found between the groups for any main outcome measures made between sessions. The MSE group showed some positive effects within-sessions, with the Interact showing significant between-group differences in immediate effects on mood (p = 0.028). There was also a significantly different change over time for within-session changes in stimulation levels (p = 0.0002) and mood (p = 0.0001) between the groups. No physiological effects were observed in relation to sessions in either group. Two MSE subjects underwent changes in medication during the study period.
Get full access to this article
View all access options for this article.
References
1.
Purdon SE, Mohr E, Ilivitsky V, Jones B. Huntington's disease: pathogenesis, diagnosis and treatment. J Psychiatr Med1994;19:359-369.
2.
Furtado S, Suchowersky O. Huntington's disease:recent advances in diagnosis and management. Can J Neurol Sci1995;22:5-12.
3.
Harper PS (ed.) Huntington's disease, second edition. London:WB Saunders, 1996.
4.
Fecteau GW, Boyne J. Behavioural relaxation training with Huntington's disease patients:a pilot study. Psychol Rep1987;61:151-157.
5.
Haggar LE, Hutchinson RB. Snoezelen:an approach to the provision of a leisure resource for people with profound and multiple handicaps. Ment Hand1991;19:51-55.
6.
Ashby M, Lindsay WR, Pitcaithly D, Brotholme S, Geelen N. Snoezelen:its effect on concentration and responsiveness in people with profound multiple handicaps. Br J Occup Ther1995;58:303-307.
7.
Pinkney L, Barker P. Snoezelen an evaluation of a sensory environment used by people who are elderly and confused. Research papers, ROMPA. Robinson & Sons, 1993.
8.
Long AP, Haig L. How do clients benefit from snoezelen? an exploratory study. Br J Occup Ther1992;55:103-106.
9.
Barker P, Pinkney L. Snoezelen:a therapeutic environment for elderly people with severe confusion. Research papers, ROMPA. Poole:Robinson & Sons, 1993.
10.
Hutchinson RB, Haggar L. The development and evaluation of a snoezelen resource for people with severe multiple disability. In:Hutchinson RB, Kewin J eds. Sensations and disability:sensory environments for leisure, snoezelen, education and therapy. Chesterfield:ROMPA, 1994:18-48.
11.
Kewin J. Snoezelen the reason and the method. In:Hutchinson RB, Kewin J eds. Sensations and disability:sensory environments for leisure, snoezelen, education and therapy. Chesterfield:ROMPA, 1994:6-17.
12.
Lindsay WR, Pitcaithly D, Geelen N, Buntin L, Broxholme S, Ashby M. A comparison of the effects of four therapy procedures on concentration and responsiveness in people with profound learning disabilities. J Intellec Dis Res1997;41:201-207.
13.
Ashby M, Lindsay WR, Pitcaithly D, Broxholme S, Geelen N. Snozelen:its effects on concentration and responsiveness in people with profound multiple handicaps. Br J Occup Ther1995;58:303-307.
14.
Spitz RA. Psychiatric therapy for infancy. Am J Orothopsychiat1950;20:623-633.
15.
Barton R. Institutional neurosis. Bristol:John Wright, 1961.
16.
Baker R, Bell S, Baker E et al. A randomized controlled trial of the effects of multisensory stimulation (MSS) for people with dementia. Br J Clin Psychol2001;40:81-96.
17.
Shoulson I, Fahn S. Huntington's disease:clinical care and evaluation. Neurology1979;29:1-3.
18.
Baker R, Hall J. REHAB:Rehabilitation and Evaluation Hall & Baker. Aberdeen:Vine Publishing, 1983.
19.
Green JG, Smith R, Gardiner M, Timbury GC. Measuring behavioural disturbances of elderly demented patients in the community and its effects on relatives:a factor analytic study. Age Aging1982;11:121-126.
20.
Baker R, Dowling Z. INTERACT. Bournemouth:Published by Research and Development Support Unit, Institute of Health and Community Studies, Bournemouth University, 1995.
21.
Gerlach J, Korsgaad S, Clemmesen P et al. The St Hans rating scale for extrapyramidal syndromes:reliability and validity. Acta Psychiatr Scand1993;87:244-252.
22.
Baker R, Bell S, Assey J et al. A randomised control trial of the Snoezelen multisensory environment for patients with dementia. Bournemouth:Published by Research and Development Support Unit, Institute of Health and Community Studies, Bournemouth University, 1998.
23.
Crowder MJ, Hand DJ. Analysis of repeated measures. London:Chapman & Hall, 1990.
24.
Warner CD, Peebles BU, Miller J, Reed R, Rodriquez S, Martin-Lewis E. The effectiveness of teaching a relaxation technique to patients undergoing cardiac catheterization. J Cardiovasc Nurs1992;6:66-75.
25.
Pender NJ. Physiologic responses of clients with essential hypertension to progressive muscle relaxation training. Res Nurs Health1984;7:197-203.
26.
Iwanaga M, Tsukamoto M. Effects of excitative and sedative music on subjective and physiological relaxation. Percept Mot Skills1997;85:287-296.
