Psychometric properties of four fear of falling rating scales in people with Parkinson’s disease

Jonasson, Stina B.; Nilsson, Maria H; Lexell, Jan

doi:10.1186/1471-2318-14-66

Cited by 56 publications

(64 citation statements)

References 45 publications

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“…These observations have important clinical implications. Near falls are more frequent than falls in PD [39, 40] and may occur also among those who do not experience falls [39, 41]. We previously found, in the same project, that history of near falls but not falls was a risk factor for future falls [12].…”

Section: Discussionmentioning

confidence: 99%

External validation of a 3-step falls prediction model in mild Parkinson’s disease

et al. 2016

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The 3-step falls prediction model (3-step model) that include history of falls, history of freezing of gait and comfortable gait speed <1.1 m/s was suggested as a clinical fall prediction tool in Parkinson’s disease (PD). We aimed to externally validate this model as well as to explore the value of additional predictors in 138 individuals with relatively mild PD. We found the discriminative ability of the 3-step model in identifying fallers to be comparable to previously studies [area under curve (AUC), 0.74; 95 % CI 0.65–0.84] and to be better than that of single predictors (AUC, 0.61–0.69). Extended analyses generated a new model for prediction of falls and near falls (AUC, 0.82; 95 % CI 0.75–0.89) including history of near falls, retropulsion according to the Nutt Retropulsion test (NRT) and tandem gait (TG). This study confirms the value of the 3-step model as a clinical falls prediction tool in relatively mild PD and illustrates that it outperforms the use of single predictors. However, to improve future outcomes, further studies are needed to firmly establish a scoring system and risk categories based on this model. The influence of methodological aspects of data collection also needs to be scrutinized. A new model for prediction of falls and near falls, including history of near falls, TG and retropulsion (NRT) may be considered as an alternative to the 3-step model, but needs to be tested in additional samples before being recommended. Taken together, our observations provide important additions to the evidence base for clinical fall prediction in PD.

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Section: Discussionmentioning

confidence: 99%

External validation of a 3-step falls prediction model in mild Parkinson’s disease

et al. 2016

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“…It needs to be acknowledged that there could be other environmental factors of importance for concerns about falling in people with PD, such as physical environmental barriers, which are not addressed in the present study. Walking on slippery surfaces was in fact ranked as the most difficult FES-I item in a previous PD study [6], and difficulties climbing stairs have been shown to be of importance for fall-related self-efficacy [12]. Accordingly, further research on the possible impact of physical environmental factors on FOF in people with PD by using more detailed data on housing and close exterior surroundings is motivated, but due to the methodological complexity of such issues specific studies are required.…”

Section: Discussionmentioning

confidence: 99%

“…The FES-I (i.e., our dependent variable) was developed by combining and modifying three other FOF scales [2], of which two are based on Bandura's theory of self-efficacy [3,4]. Although FES-I scores have been shown to correlate (r > 0.80) with self-efficacy based FOF measures [6], the findings in the present study suggest that concerns about falling are not strongly connected to general self-efficacy in people with PD.…”

Section: Discussionmentioning

confidence: 99%

“…Previous multivariate PD studies that have investigated associated factors to FOF have focused on FOF conceptualized as fall-related selfefficacy [10,12,19,20] or balance confidence [21]. Furthermore, a recent head-to-head comparison of four commonly used FOF rating scales showed that the FES-I and the modified Survey of Activities and Fear of Falling in the Elderly were the most favourable in terms of psychometric properties in people with PD [6].…”

Section: Discussionmentioning

confidence: 99%

“…The Generic Walk-12 (Walk-12G) [31] targets walking difficulties in everyday life. The Parkinson's Disease Activities of Daily Living Scale (PADLS) [32] targets difficulties in activities of daily living: those who scored ≥3 were classified as needing help from others in daily activities [6]. The Energy subscale of the Nottingham Health Profile (NHP-EN) [33] targets fatigue: those who affirmed at least one of its three dichotomous questions were classified as having fatigue [34].…”

Section: Pd-related Disabilitiesmentioning

confidence: 99%

See 2 more Smart Citations

Concerns About Falling in Parkinson’s Disease: Associations with Disabilities and Personal and Environmental Factors

Jonasson

Ullén

Iwarsson

et al. 2015

Journal of Parkinson’s Disease

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Abstract.Background: Fear of falling can be conceptualized in different ways, e.g., as concerns about falling or low fall-related selfefficacy. It is common in people with Parkinson's disease (PD), and there is growing knowledge about its contributing factors. However, previous multivariate studies have mainly focused on fear of falling in relation to PD-related disabilities, and less is known about the associations between fear of falling and personal and environmental factors. Objective: To identify explanatory factors of concerns about falling in people with PD by focusing on personal and environmental factors as well as PD-related disabilities. Methods: Data were collected from 241 persons with PD (39% women, median age 70 years, PD duration 8 years). Concerns about falling (assessed with the Falls Efficacy Scale-International, FES-I; categorized into low, moderate, or high concerns) were used as the dependent variable in a multivariate ordinal regression analysis. Personal factors, environmental factors and PD-related disabilities constituted independent variables. Results: Low, moderate and high concerns about falling were reported by 29%, 24% and 47% of the participants, respectively. Walking difficulties, orthostatism, motor symptoms, age, and fatigue (presented in order of importance) were significant (p < 0.05) explanatory factors of concerns about falling. Conclusions: Several factors significantly explained concerns about falling in people with PD. Walking difficulties was by far the strongest explanatory factor. This suggests that minimizing walking difficulties should be a primary target when aiming at reducing concerns about falling in people with PD.

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Depressive symptoms associated with concerns about falling in Parkinson's disease

et al. 2016

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BackgroundConcerns about falling, a construct related to fear of falling, is increased in people with Parkinson's disease (PD) and is recognized as a barrier for exercise, negatively affecting health‐related quality of life and participation.AimTo investigate modifiable factors associated with concerns about falling in elderly with mild‐to‐moderate PD.MethodsEighty‐nine elderly (39 females, mean age 73 years) with mild‐to‐moderate PD were recruited. Concerns about falling were assessed with the Falls Efficacy Scale‐international, that is, the dependent variable in multiple linear regression analysis. Independent variables included both motor (e.g., objective measures of physical activity and gait) and nonmotor aspects such as depressive symptoms.ResultsA model with three significant independent variables explained 33% of the variance in concerns about falling. According to the standardized regression coefficients (β), the strongest contributing factor was depressive symptoms (0.40), followed by balance performance (−0.25), and use of mobility devices (0.24).ConclusionsThe findings imply that factors associated with concerns about falling are a multifactorial phenomenon. For its management in elderly with mild‐to‐moderate PD, one should consider depressive symptoms, balance deficits, and mobility devices.

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Psychometric properties of four fear of falling rating scales in people with Parkinson’s disease

Cited by 56 publications

References 45 publications

External validation of a 3-step falls prediction model in mild Parkinson’s disease

External validation of a 3-step falls prediction model in mild Parkinson’s disease

Concerns About Falling in Parkinson’s Disease: Associations with Disabilities and Personal and Environmental Factors

Depressive symptoms associated with concerns about falling in Parkinson's disease

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