Editing Huntington's disease (section)

===Therapy===

Weight loss and problems in eating due to [[dysphagia]] and other muscle discoordination are common, making nutrition management increasingly important as the disease advances.<ref name="lancet07" /> [[Thickening agent]]s can be added to liquids, as thicker fluids are easier and safer to swallow.<ref name="lancet07" /> Reminding the affected person to eat slowly and to take smaller pieces of food into the mouth may also be of use to prevent choking.<ref name="lancet07" /> If eating becomes too hazardous or uncomfortable, the option of using a [[percutaneous endoscopic gastrostomy]] is available. This feeding tube, permanently attached through the [[abdomen]] into the [[stomach]], reduces the risk of [[pulmonary aspiration|aspirating]] food and provides better nutritional management.<ref name="pmid18390785">{{cite journal | vauthors = Panagiotakis PH, DiSario JA, Hilden K, Ogara M, Fang JC | title = DPEJ tube placement prevents aspiration pneumonia in high-risk patients | journal = Nutrition in Clinical Practice | volume = 23 | issue = 2 | pages = 172–175 | year = 2008 | pmid = 18390785 | doi = 10.1177/0884533608314537 }}</ref> Assessment and management by [[speech-language pathologist]]s with experience in Huntington's disease is recommended.<ref name="lancet07" />

People with Huntington's disease may see a [[physical therapist]] for noninvasive and nonmedication-based ways of managing the physical symptoms. Physical therapists may implement fall risk assessment and prevention, as well as strengthening, stretching, and cardiovascular exercises. [[Walking aids]] may be prescribed as appropriate. Physical therapists also prescribe breathing exercises and [[airway clearance technique]]s with the development of respiratory problems.<ref name=ehdnphysio /> Consensus guidelines on physiotherapy in Huntington's disease have been produced by the European HD Network.<ref name=ehdnphysio>{{cite web|url=http://www.euro-hd.net/html/network/groups/physio/physiotherapy-guidance-doc-2009.pdf|title=EHDN Physiotherapy Guidance Document|publisher=European HD Network Physiotherapy Working Group|access-date=2015-11-15|url-status=dead|archive-url=https://web.archive.org/web/20160304030647/http://www.euro-hd.net/html/network/groups/physio/physiotherapy-guidance-doc-2009.pdf|archive-date=4 March 2016}}</ref> Goals of early [[Rehabilitation medicine|rehabilitation]] interventions are prevention of loss of function. Participation in rehabilitation programs during the early to middle stage of the disease may be beneficial as it translates into long-term maintenance of motor and functional performance.  Rehabilitation during the late stage aims to compensate for motor and functional losses.<ref>{{cite journal|vauthors=Quin L, Busee M|title=Development of physiotherapy guidance and treatment-based classifications for people with Huntington's disease|journal=Neurodegenerative Disease Management|date=February 2012|volume=2|issue=1|pages=21–31|doi=10.2217/nmt.11.86|url=http://www.futuremedicine.com/doi/pdf/10.2217/nmt.11.67|doi-access=|access-date=10 May 2012|archive-date=9 August 2020|archive-url=https://web.archive.org/web/20200809000845/https://www.futuremedicine.com/doi/pdf/10.2217/nmt.11.67|url-status=live}}</ref> For long-term independent management, the therapist may develop home exercise programs for appropriate people.<ref>{{cite journal | vauthors = Khalil H, Quinn L, van Deursen R, Martin R, Rosser A, Busse M | title = Adherence to use of a home-based exercise DVD in people with Huntington disease: participants' perspectives | journal = Physical Therapy | volume = 92 | issue = 1 | pages = 69–82 | date = January 2012 | pmid = 21960468 | doi = 10.2522/ptj.20100438 | doi-access = free }}</ref>

Additionally, an increasing number of people with HD are turning to [[palliative care]], which aims to improve quality of life through the treatment of the symptoms and stress of serious illness, in addition to their other treatments.<ref>{{cite journal | vauthors = Travers E, Jones K, Nichol J | title = Palliative care provision in Huntington's disease | journal = International Journal of Palliative Nursing | volume = 13 | issue = 3 | pages = 125–130 | date = March 2007 | pmid = 17505405 | doi = 10.12968/ijpn.2007.13.3.23274 }}</ref>