H25 Knowledge translation of a clinical practice guideline for physical therapy management of persons with Huntington’s disease

In 2020, our group published physiotherapy clinical practice guidelines (CPG) for people with Huntington's disease (HD). The guideline recommendations were categorized according to six primary movement impairment classifications. To facilitate implementation of this CPG and knowledge translation, we have developed decision algorithms for physiotherapy assessments and interventions, including recommendations for therapists to overcome barriers to CPG implementation for people with HD. We conducted a literature review of papers that evaluated physiotherapy interventions in individuals with HD (n=26) to identify assessments for each of the primary movement impairment classifications, and then searched for papers (n=28) that reported their clinometric/psychometric properties in HD. Assessments were evaluated using modified Movement Disorder Society Committee on Rating Scales criteria and other relevant criteria. We identified a 'core set' of physiotherapy assessments for persons with HD, including the Six Minute Walk Test, Timed Up and Go Test, Berg Balance Scale, and the Medical Outcomes Study Short Form 36 (SF-36). We then developed guideline-based decision trees to assist in decision making and implementation of the CPG into practice for persons with HD across the continuum of care. Finally, we developed strategies for overcoming barriers to implementation, such as seeking specialized training in HD, engaging caretakers or family members to help the person with HD exercise and establishing clinical pathways that support early PT referrals. Knowledge translation documents are essential to promoting implementation of the physiotherapy CPG for persons with HD into clinical practice.