Handgrip strength and the Index of pulmonary dysfunction: Practical screening tools for cough dysfunction in huntington's disease

Background As Huntington's disease (HD) progresses, it impairs airway protection, increasing the risk of aspiration pneumonia—the leading cause of death in HD. Although voluntary peak cough flow (vPCF) assesses cough effectiveness, its clinical use is limited by time and equipment constraints. Objective This study evaluates handgrip strength (HGS) and the Index of Pulmonary Dysfunction (IPD) as simpler screening tools and aims to define gender-specific thresholds for identifying cough dysfunction (dystussia) in HD patients. Methods In this prospective cross-sectional study, 71 patients with HD underwent assessments of HGS, IPD, vPCF, respiratory muscle strength, and were rated using the Unified Huntington's Disease Rating Scale. Logistic regression and ROC analyses were used to assess the predictive value of HGS and IPD for dystussia (vPCF <300 L/min). Results Among 32 females and 39 males, 30 exhibited dystussia and had more advanced disease. HGS showed AUCs of 0.82 (females) and 0.89 (males), IPD 0.86 overall. Combining HGS and IPD improved accuracy. Conclusions HGS and IPD appear to be effective tools for initial dystussia screening in HD. Trial registration NCT06585332