Falling risk factors in Parkinson's disease

Robinson, Keith; Dennison, Andrew C.; Roalf, David R.; Noorigian, Joseph V.; Cianci, Heather; Bunting-Perry, Lisette; Moberg, Paul J.; Kleiner‐Fisman, Galit; Martine, Rebecca; Duda, John E.; Jaggi, Jurg L.; Stern, Matthew B.

doi:10.3233/nre-2005-20304

Cited by 89 publications

(45 citation statements)

References 62 publications

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IntroductionFalls are both common and debilitating in patients with Parkinson's disease (PD). Gait impairment is among the factors contributing to increased risk of falls in PD [1,2], together with leg muscle weakness and poor balance [2][3][4]. Indeed, patients with PD are more often admitted to hospital than healthy individuals because of a fall-related injury [5].

AbstractBackground: Gait impairment is a risk factor for falls in patients with Parkinson's disease (PD).

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confidence: 99%

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

et al. 2019

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Background Gait impairment is a risk factor for falls in patients with Parkinson’s disease (PD). Gait can be conveniently assessed by electronic walkways, but there is need to select which spatiotemporal gait variables are useful for assessing gait in PD. Existing models for gait variables developed in healthy subjects and patients with PD show some methodological shortcomings in their validation through exploratory factor analysis (EFA), and were never confirmed by confirmatory factor analysis (CFA). The aims of this study were (1) to create a new model of gait for PD through EFA, (2) to analyze the factorial structure of our new model and compare it with existing models through CFA. Results From the 37 variables initially considered in 250 patients with PD, 10 did not show good-to-excellent reliability and were eliminated, while further 19 were eliminated after correlation matrix and Kaiser–Meyer–Olkin measure. The remaining eight variables underwent EFA and three factors emerged: pace/rhythm, variability, and asymmetry. Structural validity of our new model was then examined with CFA, using the structural equation modeling. After some modifications, suggested by the Modification Indices, we obtained a final model that showed an excellent fit. In contrast, when the structure of previous models of gait was analyzed, no model achieved convergence with our sample of patients. Conclusions Our model for spatiotemporal gait variables of patients with PD is the first to be developed through an accurate EFA and confirmed by CFA. It contains eight gait variables divided into three factors and shows an excellent fit. Reasons for the non-convergence of other models could be their inclusion of highly inter-correlated or low-reliability variables or could be possibly due to the fact that they did not use more recent methods for determining the number of factors to extract.

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AbstractBackground: Gait impairment is a risk factor for falls in patients with Parkinson's disease (PD).

…”

mentioning

confidence: 99%

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

et al. 2019

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“…Postural disturbance or compromised balance in general is considered an intrinsic risk factor for falling in Parkinson's disease 94. In attempts to improve postural stability, Toole et al31 and Hirsch et al95 combined 10 weeks of lower extremity progressive resistance training (PRT) and exercises performed on unstable surfaces to promote balance and strength.…”

Section: Resistance Training Interventionsmentioning

confidence: 99%

Parkinson's disease and resistive exercise: Rationale, review, and recommendations

2008

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Individuals with Parkinson's disease (PD) are not only burdened with disease-specific symptoms (i.e., bradykinesia, rigidity, and tremor), but are also confronted with ageassociated progressive loss of physical function, perhaps to a greater extent than neurologically normal adults. Suggestions for the inclusion of resistive exercise into treatment to attenuate these symptoms were made over 10 years ago, yet very few well controlled investigations are available. The objective of this review is to establish a clear rationale for the efficacy of resistance training in individuals with PD. Specifically, we highlight musculoskeletal weakness and its relationship to function as well as potential training-induced adaptive alterations in the neuromuscular system. We also review the few resistance training interventions currently available, but limit this review to those investigations that provide a quantitative exercise prescription. Finally, we recommend future lines of inquiry warranting further attention and call to question the rationale behind current exercise prescriptions. The absence of reports contraindicating resistive exercise, the potential for positive adaptation, and the noted benefits of resistance training in other populations may provide support for its inclusion into a treatment approach to PD. © 2007 Movement Disorder Society

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“…Moreover, 90% of all patients will fall at some point in their lives [3]. Falls can cause major injuries [4] and recurrent falls can markedly reduce quality of life [5]. Therefore, it is important to improve balance in PD patients, and reduce their risk of falling.…”

Section: Introductionmentioning

confidence: 99%

The effects of vibrotactile biofeedback training on trunk sway in Parkinson's disease patients

Nanhoe-Mahabier

Allum

Pasman

et al. 2012

Parkinsonism & Related Disorders

135

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Background: Postural instability in Parkinson's disease (PD) can lead to falls, injuries and reduced quality of life. We investigated whether balance in PD can improve by offering patients feedback about their own trunk sway as a supplement to natural sensory inputs. Specifically, we investigated the effect of artificial vibrotactile biofeedback on trunk sway in PD. Methods: Twenty PD patients were assigned to a control group (n ¼ 10) or biofeedback group (n ¼ 10). First, all patients performed two sets of six gait tasks and six stance tasks (pre-training assessment). Subsequently, all subjects trained six selected tasks five times (balance training). During this training, the feedback group received vibrotactile feedback of trunk sway, via vibrations delivered at the head. After training, both groups repeated all twelve tasks (post-training assessment). During all tasks, trunk pitch and roll movements were measured with angular velocity sensors attached to the lower trunk. Outcomes included sway angle and sway angular velocity in the roll and pitch plane, and task duration. Results: Overall, patients in the feedback group had a significantly greater reduction in roll (P ¼ 0.005) and pitch (P < 0.001) sway angular velocity. Moreover, roll sway angle increased more in controls after training, suggesting better training effects in the feedback group (P < 0.001). Conclusions: One session of balance training in PD using a biofeedback system showed beneficial effects on trunk stability. Additional research should examine if these effects increase further after more intensive training, how long these persist after training has stopped, and if the observed effects carry over to non-trained tasks.

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Falling risk factors in Parkinson's disease

Cited by 89 publications

References 62 publications

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

Proposal of a new conceptual gait model for patients with Parkinson’s disease based on factor analysis

Parkinson's disease and resistive exercise: Rationale, review, and recommendations

The effects of vibrotactile biofeedback training on trunk sway in Parkinson's disease patients

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