Clinical and physiological assessments for elucidating falls risk in Parkinson's disease

The study aims were to devise (1) a fall risk screen for people with PD using routine clinical measures and (2) an explanatory (physiological) fall risk assessment for guiding fall prevention interventions. One hundred thirteen people with PD (age 66 ± 95% CI 1.6 years) underwent clinical assessment...

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Vydané v:Movement disorders Ročník 24; číslo 9; s. 1280 - 1289
Hlavní autori: Latt, Mark D., Lord, Stephen R., Morris, John G.L., Fung, Victor S.C.
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: Hoboken Wiley Subscription Services, Inc., A Wiley Company 15.07.2009
Wiley
Predmet:
accidental falls
Accidental Falls - prevention & control
Aged
Analysis of Variance
balance
Biological and medical sciences
Blood Pressure - physiology
Chi-Square Distribution
cognitive impairment
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Female
Follow-Up Studies
freezing of gait
Humans
Male
Medical sciences
Middle Aged
muscle strength
Neurologic Examination
Neurology
Neuropsychological Tests
Parkinson Disease - physiopathology
Parkinson Disease - therapy
Parkinson's disease
Predictive Value of Tests
Reaction Time - physiology
Risk Assessment - methods
Risk Factors
Sex Factors
Nervous system diseases
Cognitive disorder
Parkinson's disease
Parkinson disease
freezing of gait
Freezing
Cerebral disorder
muscle strength
balance
Central nervous system disease
Risk factor
accidental falls
Degenerative disease
cognitive impairment
Strength
Extrapyramidal syndrome
ISSN:0885-3185, 1531-8257, 1531-8257
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Popis
Shrnutí:The study aims were to devise (1) a fall risk screen for people with PD using routine clinical measures and (2) an explanatory (physiological) fall risk assessment for guiding fall prevention interventions. One hundred thirteen people with PD (age 66 ± 95% CI 1.6 years) underwent clinical assessments and quantitative tests of sway, gait, strength, reaction time, and lower limb sensation. Participants were then followed up for 12 months to determine fall incidence. In the follow‐up year, 51 participants (45%) fell one or more times whereas 62 participants (55%) did not fall. Multivariate analyses of routine clinical measures revealed that a fall in the past year, abnormal axial posture, cognitive impairment, and freezing of gait were independent risk factors for falls and predicted 38/51 fallers (75%) and 45/62 non‐fallers (73%). A multivariate model combining clinical and physiological measures that elucidate the pathophysiology of falls identified abnormal posture, freezing of gait, frontal impairment, poor leaning balance, and leg weakness as independent risk factors. This model correctly classified 39/51 fallers (77%) and 51/62 non‐fallers (82%). Patients with PD at risk of falls can be identified accurately with routine clinical assessments and quantitative physiological tests. Many of the risk factors identified are amenable to targeted intervention. © 2009 Movement Disorder Society
Bibliografia:istex:C7F838555BD8188320EB81FF0D0EF33CF0CF177C
Potential conflict of interest: Mark Latt was funded by a University of Sydney PhD Scholarship to undertake this study and Stephen Lord is supported by a NHMRC Senior Principal Research Fellowship. Stephen Lord is a company director of Balance Systems Inc, which makes equipment items for the PPA (POWMRI FallScreen) which is commercially available through the Prince of Wales Medical Research Institute.
ArticleID:MDS22561
ark:/67375/WNG-6G5ML091-8
ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:0885-3185
1531-8257
1531-8257
DOI:10.1002/mds.22561