F036 Challenging balance and gait tasks may indicate early declines in Huntington’s disease

<h3>Background</h3> Balance is affected early in the Huntington’s disease (HD) course and progressively worsens over time, impacting the ability to move safely and contributing to increased falls risk. No valid and reliable outcome measure specific to balance impairments in HD currently exists. A better understanding of tasks that decline across stages of HD may improve referrals and serve as an indicator of treatment efficacy. <h3>Aims</h3> To determine balance tasks that may differentiate HD stages. <h3>Methods</h3> In this ongoing multicenter study, we compared balance performance across HD-ISS groups using ANOVA to examine candidate tasks that may differentiate between groups. In a single session, participants completed survey measures and a battery of balance and walking tasks. <h3>Results/Outcomes</h3> 31 individuals completed testing; age: 59.3±13.7 years; HD-ISS: stage 0–2, n=7; stage 3/mild, n=8; stage 3/moderate, n=10; stage 3/severe, n=6. Single leg standing (SLS), pivot turning, sequenced step-ups, and lateral foot scooting significantly (p&lt;0.05) differentiated HD-ISS 0–2 from HD-ISS 3; while walking with a narrow base of support and transitioning from forward to backward walking differentiated HD-ISS 0–2 and 3/mild from HD-ISS 3/moderate/severe. Only walking with horizontal and vertical head turns differentiated HD-ISS 3/severe from all other groups. <h3>Conclusions</h3> Declines in tasks involving SLS may be early indicators of balance decline that should trigger referral to physiotherapy to reduce fall risk. Declines in gait may indicate further progression. This preliminary analysis lays groundwork for ongoing analyses to develop and validate an HD-specific postural control outcome measure suitable for patient monitoring, symptom management, and clinical trials.