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Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease

BACKGROUND: In 2020, our group published physical therapy clinical practice guidelines (CPG) for people with Huntington’s disease (HD). The guideline recommendations were categorized according to six primary movement impairment classifications. OBJECTIVE: To facilitate implementation of this CPG, we...

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Autores principales: Fritz, Nora E., Kegelmeyer, Deb A., Rao, Ashwini K., Quinn, Lori, Kloos, Anne D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: IOS Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837690/
https://www.ncbi.nlm.nih.gov/pubmed/36155527
http://dx.doi.org/10.3233/JHD-220549
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author Fritz, Nora E.
Kegelmeyer, Deb A.
Rao, Ashwini K.
Quinn, Lori
Kloos, Anne D.
author_facet Fritz, Nora E.
Kegelmeyer, Deb A.
Rao, Ashwini K.
Quinn, Lori
Kloos, Anne D.
author_sort Fritz, Nora E.
collection PubMed
description BACKGROUND: In 2020, our group published physical therapy clinical practice guidelines (CPG) for people with Huntington’s disease (HD). The guideline recommendations were categorized according to six primary movement impairment classifications. OBJECTIVE: To facilitate implementation of this CPG, we have developed guideline-based algorithms for physical therapy assessments and interventions and recommendations for therapists to overcome barriers to CPG implementation for people with HD. METHODS: We conducted a literature review of papers that evaluated physical therapy 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. RESULTS: We identified a “core set” of physical therapy 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 to exercise, and establishing clinical pathways that support early physical therapy referrals. CONCLUSION: Knowledge translation documents such as this are essential to promoting implementation of the physical therapy CPGs into clinical practice.
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spelling pubmed-98376902023-01-30 Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease Fritz, Nora E. Kegelmeyer, Deb A. Rao, Ashwini K. Quinn, Lori Kloos, Anne D. J Huntingtons Dis Review BACKGROUND: In 2020, our group published physical therapy clinical practice guidelines (CPG) for people with Huntington’s disease (HD). The guideline recommendations were categorized according to six primary movement impairment classifications. OBJECTIVE: To facilitate implementation of this CPG, we have developed guideline-based algorithms for physical therapy assessments and interventions and recommendations for therapists to overcome barriers to CPG implementation for people with HD. METHODS: We conducted a literature review of papers that evaluated physical therapy 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. RESULTS: We identified a “core set” of physical therapy 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 to exercise, and establishing clinical pathways that support early physical therapy referrals. CONCLUSION: Knowledge translation documents such as this are essential to promoting implementation of the physical therapy CPGs into clinical practice. IOS Press 2022-12-16 /pmc/articles/PMC9837690/ /pubmed/36155527 http://dx.doi.org/10.3233/JHD-220549 Text en © 2022 – The authors. Published by IOS Press https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial (CC BY-NC 4.0) License (https://creativecommons.org/licenses/by-nc/4.0/) , which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Fritz, Nora E.
Kegelmeyer, Deb A.
Rao, Ashwini K.
Quinn, Lori
Kloos, Anne D.
Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease
title Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease
title_full Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease
title_fullStr Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease
title_full_unstemmed Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease
title_short Clinical Decision Trees to Guide Physical Therapy Management of Persons with Huntington’s Disease
title_sort clinical decision trees to guide physical therapy management of persons with huntington’s disease
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9837690/
https://www.ncbi.nlm.nih.gov/pubmed/36155527
http://dx.doi.org/10.3233/JHD-220549
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