Many factors may make being active more difficult for someone with HD. Some of these are a result of the condition itself, like physical and cognitive factors, others may be obstacles imposed by the environment and non-disease related personal factors.

Physical Factors

The person with HD may find being active difficult because of:

  • A fear of falling due to involuntary movements (chorea) and slowness of voluntary movements (dystonia and rigidity) which may affect his/ her balance and walking ability.
  • Embarrassment at looking ‘different’ while being active in public. A general lack of fitness. If persons have not been physically active for a prolonged period of time, or they have problems with altered sleep patterns or poor nutrition they may be generally ‘unfit’. Therefore starting to be more active will be hard work, which can be de-motivating.

Cognitive Factors

The person with HD may find being active difficult because of:

  • Lack of motivation. This may occur as a direct result of the symptoms of HD, such as apathy and depression. These are common psychiatric symptoms that can make it challenging to be active.
  • Trouble getting started and trying new things. He or she may have problems engaging with any change of circumstances and daily structure.
  • Difficulty planning and organising activities in advance. This may be linked with reduced attention and concentration, and poor short-term memory.
  • Lack of insight into how active or inactive they really are. Often there is a perception that he or she is more active than in reality.

Environmental and Personal Factors

The person with HD may find being active difficult because of:

  • Low self-esteem. This could be due to a change of role within the family or inability to work due to the condition.
  • Lack of understanding as to the reasons why they should be active.
  • Lack of time or lack of interest in physical activity in general.
  • Lack of suitable facilities with appropriate equipment.
  • The cost of using exercise facilities and the cost of getting to and from the facilities is too high.
  • Lack of encouragement/expectations from health care professionals and family members to be physically active.
  • Lack of someone to be physically active with.
  • Lack of self-efficacy and belief in oneself that he or she is able to be active.