Comparison of Self-report and Performance-Based Balance Measures for Predicting Recurrent Falls in People With Parkinson Disease: Cohort Study

Almeida, Lorena Rosa S.; Valença, Guilherme T.; Negreiros, Nádja N.; Pinto, Elen Beatriz; Oliveira‐Filho, Jamary

doi:10.2522/ptj.20150168

Cited by 37 publications

(33 citation statements)

References 57 publications

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“…Other risk factors consistently associated with falls in PD include disease severity as measured by H&Y scale, 22,22,[25][26][27]31,38,[42][43][44]46,47,[50][51][52] UPDRS total score, 22,23,27,30,39,[44][45][46]50,51,53 and UPDRS motor subscore. [21][22][23]25,27,30,38,41,42,47,51,52,54,55 Studies where no association was found 24,26,39,43,44,53 may be explained by the fact that as motor features progress, the fall risk decreases as the patient becomes more sedentary. Moreover, tremor might decrease leading to lower scores in the setting of worsening gait and PI subscores with paradoxically better overall scores in fallers.…”

Section: Fall Risk Factors In Pdmentioning

confidence: 99%

“…Moreover, tremor might decrease leading to lower scores in the setting of worsening gait and PI subscores with paradoxically better overall scores in fallers. 26 Similarly, proxies for disease severity, including higher levodopa equivalent doses [22][23][24]26,27,30,39,42,44,47,52,53,55 and disease duration, have been variably identified as risk factors, [21][22][23]27,30,31,38,40,[42][43][44]46,47,[50][51][52][53][54][55] although the degree of levodopa response is not usually directly assessed. Falls can be observed preceding diagnosis 24,25 and prior to initiation of levodopa, 21 particularly in those with the postural instability and gait difficulties (PIGD) subtype.…”

Section: Fall Risk Factors In Pdmentioning

confidence: 99%

“…56 Certain motor symptoms and signs of parkinsonism are potentially modifiable risk factors. Numerous studies have identified impaired balance as a key risk factor by assessing composite measures of PI, 21,22,24,25,30,42,43,46,47,[52][53][54][55]57 anticipatory balance maneuvers, [22][23][24][25]27,31,41,42,44,52,55,[57][58][59] reactive balance maneuvers, 35,54,[57][58][59] and slowed mobility. [24][25][26]41,44,54,58 FOG is also reliably associated, [21][22][23]27,35,42,43,47,50,…”

Section: Fall Risk Factors In Pdmentioning

confidence: 99%

“…24,26,39,40,43,44,47,53 Depression is a risk factor for falls in older people without PD. 48 Other potentially modifiable risk factors include a fear of falling, which can be related to anxiety, [24][25][26]30,39,42,44,46,47,[52][53][54][55] impaired activities of daily living and reduced quality of life, 22,24,26,27,30,31,38,39,42,46,50,[52][53][54][55] reduced lower extremity strength, 23,58 and sensory dysfunction. 23,46,51,58 Fall Risk Factors in DLB…”

Section: Fall Risk Factors In Pdmentioning

confidence: 99%

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Falls in Synucleinopathies

Joza

Camicioli

2019

Can. J. Neurol. Sci.

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ABSTRACT:Parkinson’s disease (PD) and other synucleinopathies, namely dementia with Lewy bodies (DLB) and multiple system atrophy (MSA), are common degenerative neurological disorders that share synuclein pathology. Although certain cardinal features of parkinsonism, including bradykinesia and rigidity, respond well to levodopa, axial features, such as gait and balance impairment, are less reliably responsive to dopaminergic therapy and surgical interventions. Consequently, falls are common in PD and other synucleinopathies and are a major contributor toward injury and loss of independence. This underscores the need for appropriate fall risk assessment and implementation of preventative measures in all patients with parkinsonism. The aim of this review is therefore to explore modifiable and non-modifiable risk factors for falls in synucleinopathies. We next review and evaluate the evidence for pharmacological, nonpharmacological, and surgical approaches for fall prevention, and emphasize individualized and multifaceted approaches.

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Section: Fall Risk Factors In Pdmentioning

confidence: 99%

Section: Fall Risk Factors In Pdmentioning

confidence: 99%

Section: Fall Risk Factors In Pdmentioning

confidence: 99%

Section: Fall Risk Factors In Pdmentioning

confidence: 99%

See 2 more Smart Citations

Falls in Synucleinopathies

Joza

Camicioli

2019

Can. J. Neurol. Sci.

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“…The Corrected Akaike's Information Criterion (CAIC) was calculated to estimate the quality of each model, relative to other models. The model with the lowest CAIC was chosen as the best-fitting model in predicting the intensity of FoF [70]. The Youden Index was also used to determine optimal cutoff value [71].…”

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confidence: 99%

A new postural stability-indicator to predict the level of fear of falling in Parkinson’s disease patients

et al. 2020

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Background: Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson's disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error. Objectives: In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients. Methods: Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTR i s; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF-related behavior(s). Results: FTR 1/2 (the ratio between FTR 1 and FTR 2) was strongly correlated with the FES-I (r = − 0.63, p < 0.001), Pull test (r = − 0.65, p < 0.001), Timed Up and Go test (r = − 0.57, p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model of FTR 1/2 was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83. Conclusions: Using the proposed assessment technique, we can accurately predict the intensity of FoF in PD patients. Also, the FTR 1/2 index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.

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Predictors of Falls with Injuries in People with Parkinson's Disease

Castro

Valença

Pinto

et al. 2022

Movement Disord Clin Pract

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Background Falls are frequent in Parkinson's disease (PD), but there is lack of information about predictors of injurious falls. Objectives To determine predictors of falls with injuries in people with PD; to compare circumstances and consequences of falls in single and recurrent fallers. Methods Participants (n = 225) were assessed by disease‐specific, self‐report, and balance measures, and followed‐up for 12 months with a diary to record falls, their circumstances, and injuries. Univariate and multivariate analyses were performed. Circumstances and consequences of falls presented by single and recurrent fallers were compared. Results A total of 805 falls were analyzed, 107 (13%) were falls with injuries. Multivariate logistic regression model revealed that greater PD duration and higher balance confidence were protective factors; better balance during gait, outdoor falls, and falls related to extrinsic factors were risk factors for falls with injuries, when compared to falls with no injuries. Multivariate multinomial regression model revealed that, when compared to zero fall, past falls and daily levodopa equivalent dose were predictors of falls with injuries; these predictors together with disability were predictors of falls with no injuries. Single falls (n = 27; 3%) were more common outdoors because of extrinsic factors, whereas recurrent falls (n = 778; 97%) were more common indoors because of intrinsic factors. Single falls led to more injuries than recurrent falls (P < 0.05). Conclusions Different predictors of falls with injuries were obtained when different outcomes were compared. It should be noted that falls with injuries might be influenced by fall‐related activities and environmental factors. Single and recurrent falls differed on circumstances and consequences.

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Comparison of Self-report and Performance-Based Balance Measures for Predicting Recurrent Falls in People With Parkinson Disease: Cohort Study

Cited by 37 publications

References 57 publications

Falls in Synucleinopathies

Falls in Synucleinopathies

A new postural stability-indicator to predict the level of fear of falling in Parkinson’s disease patients

Predictors of Falls with Injuries in People with Parkinson's Disease

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