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Can Recurrent Falls be Predicted in Parkinson’s Disease?

Year 2017, , 97 - 102, 20.08.2017
https://doi.org/10.1501/Tipfak_0000000971

Abstract

Objective: To investigate the prevalence of recurrent falls in patients who are being followed up in Movement Disorder Outpatient Clinic, demographic and clinical characteristics of patients with recurrent falls, and relative accuracy of balance assessment for prediction of falls prospectively within 1 year.

Materials and Methods: The patients who were admitted to Movement Disorder Outpatient Clinic due to idiopathic Parkinson’s disease were consecutively included in the study. Demographic data and disease characteristics of the patients were recorded. Berg Balance Scale, Functional Reach Test, Five Times Sit-To-Stand Test and Timed Up and Go Test were used for assessment of balance. Subsequently, the patients and/or their relatives were asked to fill out fall diaries for 1 year.

Results: At the end of one year, at least one fall was detected in 47 (46.1%) and recurrent falls were detected in 35 (34.3%) out of 102 patients. The patients who had recurrent falls had a longer duration of disease, were using higher doses of levodopa and had higher disease severity according to Hoehn &Yahr staging and Unified Parkinson’s Disease Rating Scale. These patients obtained lower scores in Functional Reach Test, Five Times Sit-To-Stand Test, Timed Up and Go Test and Berg Balance Scale. According to Receiver Operating Characteristic analysis, Functional Reach Test had maximum specificity and sensitivity for prediction of falls followed by Berg Balance Scale, Timed Up and Go Test and Five Times Sit-To-Stand Test.

Conclusion: Recurrent falls have been found in approximately one-third of the patients with Parkinson’s disease. Disease progression had a negative effect on falls. While the Functional Reach Test is the most appropriate test for prediction of fall risk, Berg Balance Scale, Timed Up and Go Test and Five Times Sit-To-Stand Test were also shown to be useful. Prediction of fall risk may positively influence quality of life through preventing complications. 

References

  • 1. Duncan RP, Leddy AL, Cavanaugh JT, et al. Accuracy of fall prediction in Parkinson disease: six-month and 12-month prospective analyses. Parkinsons Dis. Hindawi Publishing Corporation; 2012;2012(3):237673.
  • 2. Allen NE, Schwarzel AK, Canning CG. Recurrent falls in Parkinson's disease: a systematic review. Parkinsons Dis. Hindawi Publishing Corporation; 2013;2013(2):906274.
  • 3. Melton LJ, Leibson CL, Achenbach SJ, et al. Fracture risk after the diagnosis of Parkinson's disease: Influence of concomitant dementia. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2006 Sep;21(9):1361–7.
  • 4. Adkin AL, Frank JS, Jog MS. Fear of falling and postural control in Parkinson's disease. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2003 May;18(5):496– 502.
  • 5. Romero DH, Stelmach GE. Changes in postural control with aging and Parkinson's disease. IEEE Eng Med Biol Mag. 2003 Mar;22(2):27–31.
  • 6. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev. 2006 Oct;12(5):290–295.
  • 7. Pickering RM, Grimbergen YAM, Rigney U, et al. A meta-analysis of six prospective studies of falling in Parkinson's disease. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2007 Oct 15;22(13):1892–1900.
  • 8. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007 Jan 3;297(1):77–86.
  • 9. Sterke CS, Verhagen AP, van Beeck EF, van der Cammen TJM. The influence of drug use on fall incidents among nursing home residents: a systematic review. Int Psychogeriatr. Cambridge University Press; 2008 Oct;20(5):890–910.
  • 10. Bloch F, Thibaud M, Dugué B, et al. Episodes of falling among elderly people: a systematic review and meta-analysis of social and demographic pre-disposing characteristics. Clinics (Sao Paulo); 2010;65(9):895–903.
  • 11. Letts L, Moreland J, Richardson J, et al. The physical environment as a fall risk factor in older adults: Systematic review and metaanalysis of cross-sectional and cohort studies. Aust Occup Ther J. Blackwell Publishing Ltd; 2010 Feb;57(1):51–64.
  • 12. Horak FB, Dimitrova D, Nutt JG. Directionspecific postural instability in subjects with Parkinson's disease. Experimental Neurology. 2005 Jun;193(2):504–521.
  • 13. Dibble LE, Christensen J, Ballard DJ, Foreman KB. Diagnosis of fall risk in Parkinson disease: an analysis of individual and collective clinical balance test interpretation. Phys Ther. 2008 Mar;88(3):323–332.
  • 14. Bloem BR, Marinus J, Almeida Q, et al. Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations. SánchezFerro Á, Maetzler W, editors. Movement Disorders. 2016 Sep;31(9):1342–1355.
  • 15. Goetz CG, Poewe W, Rascol O, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2004 Sep;19(9):1020–1008.
  • 16. Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. The Unified Parkinson's Disease Rating Scale (UPDRS): Status and recommendations. Mov Disord. 2003 Jun 13;18(7):738–750.
  • 17. Lu C-H, Tang S-T, Lei Y-X, et al. Community-based interventions in hypertensive patients: a comparison of three health education strategies. BMC Public Health. BioMed Central; 2015 Jan 29;15(1):33.
  • 18. Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatr. BMJ Publishing Group Ltd; 2002 Jun 1;72(6):721–725.
  • 19. Fuller GF. Falls in the elderly. Am Fam Physician. 2000 Apr 1;61(7):2159–68–2173–4.
  • 20. Akobeng AK. Understanding diagnostic tests 3: Receiver operating characteristic curves. Acta Paediatr. Blackwell Publishing Ltd; 2007 May;96(5):644–647.
  • 21. Dibble LE, Lange M. Predicting Falls In Individuals with Parkinson Disease: A Reconsideration of Clinical Balance Measures. Journal of Neurologic Physical Therapy. 2006 Jun 1;30(2):60–67.
  • 22. Landers MR, Backlund A, Davenport J, et al. Postural Instability in Idiopathic Parkinson’s Disease: Discriminating Fallers from Nonfallers Based on Standardized Clinical Measures. Journal of Neurologic Physical Therapy. 2008 Jun 1;32(2):56–61.
  • 23. Cole MH, Silburn PA, Wood JM, Worringham CJ, Kerr GK. Falls in Parkinson's disease: kinematic evidence for impaired head and trunk control. Movement Disorders. 2010 Oct 30;25(14):2369–2378.
  • 24. Latt MD, Lord SR, Morris JGL, Fung VSC. Clinical and physiological assessments for elucidating falls risk in Parkinson's disease. Movement Disorders. 2009 Jul 15;24(9):1280–1289.
  • 25. Mak MKY, Pang MYC. Parkinsonian single fallers versus recurrent fallers: different fall characteristics and clinical features. J Neurol. Springer-Verlag; 2010 May 7;257(9):1543– 1551.
  • 26. Almeida LRS, Valença GT, Negreiros NN, Pinto EB, Oliveira-Filho J. Recurrent Falls in People with Parkinson's Disease without Cognitive Impairment: Focusing on Modifiable Risk Factors. Parkinsons Dis. Hindawi Publishing Corporation; 2014;2014(4):432924.
  • 27. Tanji H, Gruber-Baldini AL, Anderson KE, et al. A comparative study of physical performance measures in Parkinson's disease. Movement Disorders. Wiley Subscription Services, Inc., A Wiley Company; 2008 Oct 15;23(13):1897–1905.
  • 28. Kerr GK, Worringham CJ, Cole MH, et al. Predictors of future falls in Parkinson disease. 2010 Jul 13;75(2):116–124.
  • 29. Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatr. BMJ Publishing Group Ltd; 2008 Apr;79(4):368–376.
  • 30. Armand S, Landis T, Sztajzel R, Burkhard PR. Dyskinesia-induced postural instability in Parkinson's disease. 2009 Jun;15(5):359–364.
  • 31. Contreras A, Grandas F. Risk of falls in Parkinson's disease: a cross-sectional study of 160 patients. Parkinsons Dis. Hindawi Publishing Corporation; 2012;2012(4):362572.
  • 32. Matinolli M, Korpelainen JT, Korpelainen R, et al. Postural sway and falls in Parkinson's disease: a regression approach. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2007 Oct 15;22(13):1927–1935.
Year 2017, , 97 - 102, 20.08.2017
https://doi.org/10.1501/Tipfak_0000000971

Abstract

References

  • 1. Duncan RP, Leddy AL, Cavanaugh JT, et al. Accuracy of fall prediction in Parkinson disease: six-month and 12-month prospective analyses. Parkinsons Dis. Hindawi Publishing Corporation; 2012;2012(3):237673.
  • 2. Allen NE, Schwarzel AK, Canning CG. Recurrent falls in Parkinson's disease: a systematic review. Parkinsons Dis. Hindawi Publishing Corporation; 2013;2013(2):906274.
  • 3. Melton LJ, Leibson CL, Achenbach SJ, et al. Fracture risk after the diagnosis of Parkinson's disease: Influence of concomitant dementia. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2006 Sep;21(9):1361–7.
  • 4. Adkin AL, Frank JS, Jog MS. Fear of falling and postural control in Parkinson's disease. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2003 May;18(5):496– 502.
  • 5. Romero DH, Stelmach GE. Changes in postural control with aging and Parkinson's disease. IEEE Eng Med Biol Mag. 2003 Mar;22(2):27–31.
  • 6. Stevens JA, Corso PS, Finkelstein EA, Miller TR. The costs of fatal and non-fatal falls among older adults. Inj Prev. 2006 Oct;12(5):290–295.
  • 7. Pickering RM, Grimbergen YAM, Rigney U, et al. A meta-analysis of six prospective studies of falling in Parkinson's disease. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2007 Oct 15;22(13):1892–1900.
  • 8. Ganz DA, Bao Y, Shekelle PG, Rubenstein LZ. Will my patient fall? JAMA. 2007 Jan 3;297(1):77–86.
  • 9. Sterke CS, Verhagen AP, van Beeck EF, van der Cammen TJM. The influence of drug use on fall incidents among nursing home residents: a systematic review. Int Psychogeriatr. Cambridge University Press; 2008 Oct;20(5):890–910.
  • 10. Bloch F, Thibaud M, Dugué B, et al. Episodes of falling among elderly people: a systematic review and meta-analysis of social and demographic pre-disposing characteristics. Clinics (Sao Paulo); 2010;65(9):895–903.
  • 11. Letts L, Moreland J, Richardson J, et al. The physical environment as a fall risk factor in older adults: Systematic review and metaanalysis of cross-sectional and cohort studies. Aust Occup Ther J. Blackwell Publishing Ltd; 2010 Feb;57(1):51–64.
  • 12. Horak FB, Dimitrova D, Nutt JG. Directionspecific postural instability in subjects with Parkinson's disease. Experimental Neurology. 2005 Jun;193(2):504–521.
  • 13. Dibble LE, Christensen J, Ballard DJ, Foreman KB. Diagnosis of fall risk in Parkinson disease: an analysis of individual and collective clinical balance test interpretation. Phys Ther. 2008 Mar;88(3):323–332.
  • 14. Bloem BR, Marinus J, Almeida Q, et al. Measurement instruments to assess posture, gait, and balance in Parkinson's disease: Critique and recommendations. SánchezFerro Á, Maetzler W, editors. Movement Disorders. 2016 Sep;31(9):1342–1355.
  • 15. Goetz CG, Poewe W, Rascol O, et al. Movement Disorder Society Task Force report on the Hoehn and Yahr staging scale: status and recommendations. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2004 Sep;19(9):1020–1008.
  • 16. Movement Disorder Society Task Force on Rating Scales for Parkinson's Disease. The Unified Parkinson's Disease Rating Scale (UPDRS): Status and recommendations. Mov Disord. 2003 Jun 13;18(7):738–750.
  • 17. Lu C-H, Tang S-T, Lei Y-X, et al. Community-based interventions in hypertensive patients: a comparison of three health education strategies. BMC Public Health. BioMed Central; 2015 Jan 29;15(1):33.
  • 18. Wood BH, Bilclough JA, Bowron A, Walker RW. Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study. J Neurol Neurosurg Psychiatr. BMJ Publishing Group Ltd; 2002 Jun 1;72(6):721–725.
  • 19. Fuller GF. Falls in the elderly. Am Fam Physician. 2000 Apr 1;61(7):2159–68–2173–4.
  • 20. Akobeng AK. Understanding diagnostic tests 3: Receiver operating characteristic curves. Acta Paediatr. Blackwell Publishing Ltd; 2007 May;96(5):644–647.
  • 21. Dibble LE, Lange M. Predicting Falls In Individuals with Parkinson Disease: A Reconsideration of Clinical Balance Measures. Journal of Neurologic Physical Therapy. 2006 Jun 1;30(2):60–67.
  • 22. Landers MR, Backlund A, Davenport J, et al. Postural Instability in Idiopathic Parkinson’s Disease: Discriminating Fallers from Nonfallers Based on Standardized Clinical Measures. Journal of Neurologic Physical Therapy. 2008 Jun 1;32(2):56–61.
  • 23. Cole MH, Silburn PA, Wood JM, Worringham CJ, Kerr GK. Falls in Parkinson's disease: kinematic evidence for impaired head and trunk control. Movement Disorders. 2010 Oct 30;25(14):2369–2378.
  • 24. Latt MD, Lord SR, Morris JGL, Fung VSC. Clinical and physiological assessments for elucidating falls risk in Parkinson's disease. Movement Disorders. 2009 Jul 15;24(9):1280–1289.
  • 25. Mak MKY, Pang MYC. Parkinsonian single fallers versus recurrent fallers: different fall characteristics and clinical features. J Neurol. Springer-Verlag; 2010 May 7;257(9):1543– 1551.
  • 26. Almeida LRS, Valença GT, Negreiros NN, Pinto EB, Oliveira-Filho J. Recurrent Falls in People with Parkinson's Disease without Cognitive Impairment: Focusing on Modifiable Risk Factors. Parkinsons Dis. Hindawi Publishing Corporation; 2014;2014(4):432924.
  • 27. Tanji H, Gruber-Baldini AL, Anderson KE, et al. A comparative study of physical performance measures in Parkinson's disease. Movement Disorders. Wiley Subscription Services, Inc., A Wiley Company; 2008 Oct 15;23(13):1897–1905.
  • 28. Kerr GK, Worringham CJ, Cole MH, et al. Predictors of future falls in Parkinson disease. 2010 Jul 13;75(2):116–124.
  • 29. Jankovic J. Parkinson's disease: clinical features and diagnosis. J Neurol Neurosurg Psychiatr. BMJ Publishing Group Ltd; 2008 Apr;79(4):368–376.
  • 30. Armand S, Landis T, Sztajzel R, Burkhard PR. Dyskinesia-induced postural instability in Parkinson's disease. 2009 Jun;15(5):359–364.
  • 31. Contreras A, Grandas F. Risk of falls in Parkinson's disease: a cross-sectional study of 160 patients. Parkinsons Dis. Hindawi Publishing Corporation; 2012;2012(4):362572.
  • 32. Matinolli M, Korpelainen JT, Korpelainen R, et al. Postural sway and falls in Parkinson's disease: a regression approach. Mov Disord. Wiley Subscription Services, Inc., A Wiley Company; 2007 Oct 15;22(13):1927–1935.
There are 32 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Articles
Authors

Erhan Arif Öztürk This is me

Publication Date August 20, 2017
Published in Issue Year 2017

Cite

APA Öztürk, E. A. (2017). Can Recurrent Falls be Predicted in Parkinson’s Disease?. Ankara Üniversitesi Tıp Fakültesi Mecmuası, 70(2), 97-102. https://doi.org/10.1501/Tipfak_0000000971
AMA Öztürk EA. Can Recurrent Falls be Predicted in Parkinson’s Disease?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. August 2017;70(2):97-102. doi:10.1501/Tipfak_0000000971
Chicago Öztürk, Erhan Arif. “Can Recurrent Falls Be Predicted in Parkinson’s Disease?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70, no. 2 (August 2017): 97-102. https://doi.org/10.1501/Tipfak_0000000971.
EndNote Öztürk EA (August 1, 2017) Can Recurrent Falls be Predicted in Parkinson’s Disease?. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70 2 97–102.
IEEE E. A. Öztürk, “Can Recurrent Falls be Predicted in Parkinson’s Disease?”, Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 70, no. 2, pp. 97–102, 2017, doi: 10.1501/Tipfak_0000000971.
ISNAD Öztürk, Erhan Arif. “Can Recurrent Falls Be Predicted in Parkinson’s Disease?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası 70/2 (August 2017), 97-102. https://doi.org/10.1501/Tipfak_0000000971.
JAMA Öztürk EA. Can Recurrent Falls be Predicted in Parkinson’s Disease?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70:97–102.
MLA Öztürk, Erhan Arif. “Can Recurrent Falls Be Predicted in Parkinson’s Disease?”. Ankara Üniversitesi Tıp Fakültesi Mecmuası, vol. 70, no. 2, 2017, pp. 97-102, doi:10.1501/Tipfak_0000000971.
Vancouver Öztürk EA. Can Recurrent Falls be Predicted in Parkinson’s Disease?. Ankara Üniversitesi Tıp Fakültesi Mecmuası. 2017;70(2):97-102.