Which combination of strategies is used in Huntington's disease therapy?

• A. 60% HR max with internal cues
• B. 70% HR max with external cues
• C. 50% HR max with no cues
• D. 70% HR max with external cues (visual, auditory, cognitive)

Answer: (D)

External cueing combined with moderate aerobic effort best supports movement control in Huntington's disease. The disease often disrupts internal timing and self-pacing due to basal ganglia dysfunction, so giving an outside source of rhythm or cues helps patients initiate and regulate movement more consistently. Visual cues (like lines on the floor), auditory cues (such as a metronome or music with a steady beat), and cognitive cues (simple counting or rhythm strategies) provide a reliable scaffold for gait and coordination, reducing variability and improving safety.

Pairing this with about 70% of maximum heart rate targets moderate-intensity aerobic training, which improves cardiovascular fitness and can have positive effects on motor symptoms and fatigue, while remaining tolerable for people with HD who may be sensitive to overexertion and balance challenges. This combination is more effective than relying on internal cues alone or using no cues, and a lower intensity would not maximize endurance or the neuroplastic benefits of exercise.