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ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE

Year 2026, Volume: 14 Issue: 1, 1 - 12, 09.01.2026
https://doi.org/10.30720/ered.1651972

Abstract

Purpose: The Parkinson’s Disease Falls Questionnaire (PDF-Q) was developed to systematically assess fall history and associated factors in Parkinson’ Disease (PD). This study aimed to adapt the PDF-Q for the Turkish population. Material and Methods: A total of 51 individuals diagnosed with PD (aged 40–80) were included. The translation and cross-cultural adaptation of the questionnaire were conducted according to standard guidelines. The test-retest reliability of the Turkish PDF-Q was assessed with a 10-day interval. The Intraclass Correlation Coefficient (ICC) and Kappa statistics were used for analysis. Results: Questions assessing the fall experiences in the past 12 months (κ=0.564) and near-falls (κ=0.551) demonstrated moderate agreement, while questions regarding the location of indoor falls (κ=0.848) and near-falls (κ=0.801) showed strong agreement. The ICC values for the number of indoor (0.957) and outdoor (0.939) falls indicated strong agreement, whereas the ICC values for the number of indoor (0.987) and outdoor (0.993) near-falls also demonstrated strong agreement. Discussion: The Turkish adaptation of the PDF-Q demonstrated good test-retest reliability and currently stands as the only available validated tool for assessing fall history and circumstances in individuals with PD in Turkish. Although its reliability against other tools has not yet been tested, it can still be effectively used in clinical and research settings to assess falling and inform preventive strategies.

Ethical Statement

Ethical approval for the study was obtained from the Scientific Research and Publication Ethics Committee of Istanbul Medeniyet University.

References

  • Balestrino, R., & Schapira, A. H. V. (2020). Parkinson disease. European Journal of Neurology, 27(1), 27–42. https://doi.org/10.1111/ene.14108
  • Basterra, M. del R., Trumbull, E., & Solano-Flores, G. (Eds.). (2011). Cultural validity in assessment: Addressing linguistic and cultural diversity. Routledge. https://doi.org/10.4324/9780203850954
  • Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186-3191.
  • Blackman, N. J. M., & Koval, J. J. (2000). Interval estimation for Cohen’s kappa as a measure of agreement. Statistics in Medicine, 19(5), 723–741. https://doi.org/10.1002/(SICI)1097-0258(20000315)19:5<723::AID-SIM379>3.0.CO;2-A
  • Canning, C. G., Allen, N. E., Nackaerts, E., Paul, S. S., Nieuwboer, A., & Gilat, M. (2020). Virtual reality in research and rehabilitation of gait and balance in Parkinson disease. Nature Reviews Neurology, 16(8), 409–425. https://doi.org/10.1038/s41582-020-0370-2
  • Citro, S., Lazzaro, G. D., Cimmino, A. T., Giuffrè, G. M., Marra, C., & Calabresi, P. (2024). A multiple hits hypothesis for memory dysfunction in Parkinson disease. Nature Reviews Neurology, 20(1), 50–61. https://doi.org/10.1038/s41582-023-00905-z
  • Contreras, A., & Grandas, F. (2012). Risk of falls in Parkinson’s disease: a cross-sectional study of 160 patients. Parkinson’s Disease, 2012(1), 362572. https://doi.org/10.1155/2012/362572
  • Crenshaw, J. R., Bernhardt, K. A., Achenbach, S. J., Atkinson, E. J., Khosla, S., Kaufman, K. R., et al. (2017). The circumstances, orientations, and impact locations of falls in community-dwelling older women. Archives of gerontology and geriatrics, 73, 240-247.
  • Del Din, S., Godfrey, A., Galna, B., Lord, S., & Rochester, L. (2016). Free-living gait characteristics in ageing and Parkinson’s disease: impact of environment and ambulatory bout length. Journal of NeuroEngineering and Rehabilitation, 13(1), 1-12. https://doi.org/10.1186/s12984-016-0154-5
  • Diefenbach, T. (2009). Are case studies more than sophisticated storytelling?: methodological problems of qualitative empirical research mainly based on semi-structured interviews. Quality and Quantity, 43(6), 875–894. https://doi.org/10.1007/s11135-008-9164-0
  • Dorsey, E. R., Elbaz, A., Nichols, E., Abbasi, N., Abd-Allah, F., Abdelalim, A., et al. (2018). Global, regional, and national burden of Parkinson’s disease, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 17(11), 939–953. https://doi.org/10.1016/S1474-4422(18)30295-3
  • Frank, A., Bendig, J., Finkbeiner, S., Hähnel, T., Schnalke, N., Feige, T., et al. (2022). Development and validation of a fall questionnaire for patients with Parkinson's disease. Movement disorders clinical practice, 9(7), 900-908.
  • Harris, D. M., Duckham, R. L., Daly, R. M., Abbott, G., Johnson, L., Rantalainen, T., et al. (2021). Development of a Parkinson’s disease specific falls questionnaire. BMC Geriatrics, 21(1), 1-18. https://doi.org/10.1186/s12877-021-02555-6
  • Hunter, H., Rochester, L., Morris, R., & Lord, S. (2018). Longitudinal falls data in Parkinson’s disease: feasibility of fall diaries and effect of attrition. Disability and Rehabilitation, 40(19), 2236–2241. https://doi.org/10.1080/09638288.2017.1329357
  • Inglés, M., Aguilar-Rodríguez, M., Sempere-Rubio, N., & Serra-Añó, P. (2020). Potential use of a smartphone test to assess balance and risk of falls among Parkinson disease’ patients. Gait & Posture, 81, 168–169. https://doi.org/10.1016/j.gaitpost.2020.07.119
  • Lamont, R. M., Morris, M. E., Menz, H. B., McGinley, J. L., & Brauer, S. G. (2017). Falls in people with Parkinson’s disease: a prospective comparison of community and home-based falls. Gait and Posture, 55, 62–67. https://doi.org/10.1016/j.gaitpost.2017.04.005
  • Liljequist, D., Elfving, B., & Roaldsen, K. S. (2019). Intraclass correlation – A discussion and demonstration of basic features. PLoS ONE, 14(7), e0219854. https://doi.org/10.1371/journal.pone.0219854
  • Lindholm, B., Hagell, P., Hansson, O., & Nilsson, M. H. (2015). Prediction of falls and/or near falls in people with mild Parkinson’s disease. PloS one, 10(1), e0117018.
  • Liu, W. Y., Tung, T. H., Zhang, C., & Shi, L. (2022). Systematic review for the prevention and management of falls and fear of falling in patients with Parkinson’s disease. Brain and Behavior, 12(8), e2690. https://doi.org/10.1002/brb3.2690
  • Macchi, Z. A., Koljack, C. E., Miyasaki, J. M., Katz, M., Galifianakis, N., Prizer, L. P., et al. (2020). Patient and caregiver characteristics associated with caregiver burden in Parkinson’s disease: a palliative care approach. Annals of Palliative Medicine, 9(Suppl 1), S24–S33. https://doi.org/10.21037/apm.2019.10.01
  • Mak, M. K. Y., & Wong-Yu, I. S. K. (2019). Exercise for Parkinson’s disease. International Review of Neurobiology, 147, 1–44. https://doi.org/10.1016/bs.irn.2019.06.001
  • Murueta-Goyena, A., Muiño, O., & Gómez-Esteban, J. C. (2024). Prognostic factors for falls in Parkinson’s disease: a systematic review. Acta Neurologica Belgica, 124(2), 395–406. https://doi.org/10.1007/s13760-023-02428-2
  • Obrist, S., Rogan, S., & Hilfiker, R. (2016). Development and evaluation of an online Fall‐Risk Questionnaire for nonfrail community‐dwelling elderly persons: a Pilot Study. Current gerontology and geriatrics research, 2016(1), 1520932.
  • Park, S. H. (2018). Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging clinical and experimental research, 30(1), 1-16.
  • Pelicioni, P. H. S., Menant, J. C., Latt, M. D., & Lord, S. R. (2019). Falls in parkinson’s disease subtypes: Risk factors, locations and circumstances. International Journal of Environmental Research and Public Health, 16(12), 2216. https://doi.org/10.3390/ijerph16122216
  • Rahman, S., Griffin, H. J., Quinn, N. P., & Jahanshahi, M. (2008). Quality of life in Parkinson’s disease: the relative importance of the symptoms. Movement Disorders: Official Journal of the Movement Disorder Society, 23(10), 1428–1434. https://doi.org/10.1002/mds.21667
  • Sanders, K. M., Lim, K., Stuart, A. L., Macleod, A., Scott, D., Nicholson, G. C., et al. (2017). Diversity in fall characteristics hampers effective prevention: the precipitants, the environment, the fall and the injury. Osteoporosis international, 28(10), 3005-3015.
  • Soh, S. E., McGinley, J. L., Watts, J. J., Iansek, R., Murphy, A. T., Menz, H. B., et al. (2013). Determinants of health-related quality of life in people with Parkinson’s disease: a path analysis. Quality of Life Research, 22(7), 1543–1553. https://doi.org/10.1007/s11136-012-0289-1
  • Wales, J., Moore, J., Naisby, J., Ratcliffe, N., Barry, G., Amjad, A., et al. (2024). Coproduction and usability of a smartphone app for falls reporting in Parkinson disease. Physical Therapy, 104(2), pzad076. https://doi.org/10.1093/ptj/pzad076

Parkinson Hastalığında Düşmelerin Değerlendirilmesi: Parkinson Hastalığı Düşme Anketinin Türkçeye Uyarlanması

Year 2026, Volume: 14 Issue: 1, 1 - 12, 09.01.2026
https://doi.org/10.30720/ered.1651972

Abstract

Amaç: Parkinson Hastalığı Düşme Anketi (PDF-Q), Parkinson Hastalığında (PD) düşme geçmişini ve ilişkili faktörleri sistematik olarak değerlendirmek için geliştirilmiştir. Bu çalışmanın amacı PDF-Q'yu Türk toplumuna uyarlamaktır. Gereç ve Yöntem: PD tanısı konmuş toplam 51 birey (yaşları 40-80 arasında) çalışmaya dahil edildi. Anketin çevirisi ve kültürler arası uyarlaması standart kılavuzlara göre yapıldı. Türkçe PDF-Q'nun test-tekrar test güvenilirliği 10 günlük bir aralıkla değerlendirildi. Analiz için Sınıf İçi Korelasyon Katsayısı (ICC) ve Kappa istatistikleri kullanıldı. Sonuçlar: Geçtiğimiz 12 aydaki düşme deneyimlerini (κ=0,564) ve tökezlemeleri (κ=0,551) değerlendiren sorular orta düzeyde uyum gösterirken, iç mekanda düşmelerin yeri (κ=0,848) ve tökezleme durumlarını (κ=0,801) değerlendiren sorular güçlü uyum gösterdi. Kapalı alanda (0,957) ve açık alanda (0,939) düşme sayısı için ICC değerleri güçlü bir uyum gösterirken, kapalı alanda (0,987) ve açık alanda (0,993) tökezleme sayısı için ICC değerleri de güçlü bir uyum gösterdi. Tartışma: PDF-Q'nun Türkçe uyarlaması, PD'li bireylerde düşme geçmişini ve koşullarını değerlendirmek için güvenilir bir araçtır. Bu doğrulanmış anket, klinik ortamlarda ve araştırmalarda düşme riskini değerlendirmek ve Türk PD hastaları için özel olarak tasarlanmış önleyici stratejiler geliştirmek için etkili bir şekilde kullanılabilir.

References

  • Balestrino, R., & Schapira, A. H. V. (2020). Parkinson disease. European Journal of Neurology, 27(1), 27–42. https://doi.org/10.1111/ene.14108
  • Basterra, M. del R., Trumbull, E., & Solano-Flores, G. (Eds.). (2011). Cultural validity in assessment: Addressing linguistic and cultural diversity. Routledge. https://doi.org/10.4324/9780203850954
  • Beaton, D. E., Bombardier, C., Guillemin, F., & Ferraz, M. B. (2000). Guidelines for the process of cross-cultural adaptation of self-report measures. Spine, 25(24), 3186-3191.
  • Blackman, N. J. M., & Koval, J. J. (2000). Interval estimation for Cohen’s kappa as a measure of agreement. Statistics in Medicine, 19(5), 723–741. https://doi.org/10.1002/(SICI)1097-0258(20000315)19:5<723::AID-SIM379>3.0.CO;2-A
  • Canning, C. G., Allen, N. E., Nackaerts, E., Paul, S. S., Nieuwboer, A., & Gilat, M. (2020). Virtual reality in research and rehabilitation of gait and balance in Parkinson disease. Nature Reviews Neurology, 16(8), 409–425. https://doi.org/10.1038/s41582-020-0370-2
  • Citro, S., Lazzaro, G. D., Cimmino, A. T., Giuffrè, G. M., Marra, C., & Calabresi, P. (2024). A multiple hits hypothesis for memory dysfunction in Parkinson disease. Nature Reviews Neurology, 20(1), 50–61. https://doi.org/10.1038/s41582-023-00905-z
  • Contreras, A., & Grandas, F. (2012). Risk of falls in Parkinson’s disease: a cross-sectional study of 160 patients. Parkinson’s Disease, 2012(1), 362572. https://doi.org/10.1155/2012/362572
  • Crenshaw, J. R., Bernhardt, K. A., Achenbach, S. J., Atkinson, E. J., Khosla, S., Kaufman, K. R., et al. (2017). The circumstances, orientations, and impact locations of falls in community-dwelling older women. Archives of gerontology and geriatrics, 73, 240-247.
  • Del Din, S., Godfrey, A., Galna, B., Lord, S., & Rochester, L. (2016). Free-living gait characteristics in ageing and Parkinson’s disease: impact of environment and ambulatory bout length. Journal of NeuroEngineering and Rehabilitation, 13(1), 1-12. https://doi.org/10.1186/s12984-016-0154-5
  • Diefenbach, T. (2009). Are case studies more than sophisticated storytelling?: methodological problems of qualitative empirical research mainly based on semi-structured interviews. Quality and Quantity, 43(6), 875–894. https://doi.org/10.1007/s11135-008-9164-0
  • Dorsey, E. R., Elbaz, A., Nichols, E., Abbasi, N., Abd-Allah, F., Abdelalim, A., et al. (2018). Global, regional, and national burden of Parkinson’s disease, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. The Lancet Neurology, 17(11), 939–953. https://doi.org/10.1016/S1474-4422(18)30295-3
  • Frank, A., Bendig, J., Finkbeiner, S., Hähnel, T., Schnalke, N., Feige, T., et al. (2022). Development and validation of a fall questionnaire for patients with Parkinson's disease. Movement disorders clinical practice, 9(7), 900-908.
  • Harris, D. M., Duckham, R. L., Daly, R. M., Abbott, G., Johnson, L., Rantalainen, T., et al. (2021). Development of a Parkinson’s disease specific falls questionnaire. BMC Geriatrics, 21(1), 1-18. https://doi.org/10.1186/s12877-021-02555-6
  • Hunter, H., Rochester, L., Morris, R., & Lord, S. (2018). Longitudinal falls data in Parkinson’s disease: feasibility of fall diaries and effect of attrition. Disability and Rehabilitation, 40(19), 2236–2241. https://doi.org/10.1080/09638288.2017.1329357
  • Inglés, M., Aguilar-Rodríguez, M., Sempere-Rubio, N., & Serra-Añó, P. (2020). Potential use of a smartphone test to assess balance and risk of falls among Parkinson disease’ patients. Gait & Posture, 81, 168–169. https://doi.org/10.1016/j.gaitpost.2020.07.119
  • Lamont, R. M., Morris, M. E., Menz, H. B., McGinley, J. L., & Brauer, S. G. (2017). Falls in people with Parkinson’s disease: a prospective comparison of community and home-based falls. Gait and Posture, 55, 62–67. https://doi.org/10.1016/j.gaitpost.2017.04.005
  • Liljequist, D., Elfving, B., & Roaldsen, K. S. (2019). Intraclass correlation – A discussion and demonstration of basic features. PLoS ONE, 14(7), e0219854. https://doi.org/10.1371/journal.pone.0219854
  • Lindholm, B., Hagell, P., Hansson, O., & Nilsson, M. H. (2015). Prediction of falls and/or near falls in people with mild Parkinson’s disease. PloS one, 10(1), e0117018.
  • Liu, W. Y., Tung, T. H., Zhang, C., & Shi, L. (2022). Systematic review for the prevention and management of falls and fear of falling in patients with Parkinson’s disease. Brain and Behavior, 12(8), e2690. https://doi.org/10.1002/brb3.2690
  • Macchi, Z. A., Koljack, C. E., Miyasaki, J. M., Katz, M., Galifianakis, N., Prizer, L. P., et al. (2020). Patient and caregiver characteristics associated with caregiver burden in Parkinson’s disease: a palliative care approach. Annals of Palliative Medicine, 9(Suppl 1), S24–S33. https://doi.org/10.21037/apm.2019.10.01
  • Mak, M. K. Y., & Wong-Yu, I. S. K. (2019). Exercise for Parkinson’s disease. International Review of Neurobiology, 147, 1–44. https://doi.org/10.1016/bs.irn.2019.06.001
  • Murueta-Goyena, A., Muiño, O., & Gómez-Esteban, J. C. (2024). Prognostic factors for falls in Parkinson’s disease: a systematic review. Acta Neurologica Belgica, 124(2), 395–406. https://doi.org/10.1007/s13760-023-02428-2
  • Obrist, S., Rogan, S., & Hilfiker, R. (2016). Development and evaluation of an online Fall‐Risk Questionnaire for nonfrail community‐dwelling elderly persons: a Pilot Study. Current gerontology and geriatrics research, 2016(1), 1520932.
  • Park, S. H. (2018). Tools for assessing fall risk in the elderly: a systematic review and meta-analysis. Aging clinical and experimental research, 30(1), 1-16.
  • Pelicioni, P. H. S., Menant, J. C., Latt, M. D., & Lord, S. R. (2019). Falls in parkinson’s disease subtypes: Risk factors, locations and circumstances. International Journal of Environmental Research and Public Health, 16(12), 2216. https://doi.org/10.3390/ijerph16122216
  • Rahman, S., Griffin, H. J., Quinn, N. P., & Jahanshahi, M. (2008). Quality of life in Parkinson’s disease: the relative importance of the symptoms. Movement Disorders: Official Journal of the Movement Disorder Society, 23(10), 1428–1434. https://doi.org/10.1002/mds.21667
  • Sanders, K. M., Lim, K., Stuart, A. L., Macleod, A., Scott, D., Nicholson, G. C., et al. (2017). Diversity in fall characteristics hampers effective prevention: the precipitants, the environment, the fall and the injury. Osteoporosis international, 28(10), 3005-3015.
  • Soh, S. E., McGinley, J. L., Watts, J. J., Iansek, R., Murphy, A. T., Menz, H. B., et al. (2013). Determinants of health-related quality of life in people with Parkinson’s disease: a path analysis. Quality of Life Research, 22(7), 1543–1553. https://doi.org/10.1007/s11136-012-0289-1
  • Wales, J., Moore, J., Naisby, J., Ratcliffe, N., Barry, G., Amjad, A., et al. (2024). Coproduction and usability of a smartphone app for falls reporting in Parkinson disease. Physical Therapy, 104(2), pzad076. https://doi.org/10.1093/ptj/pzad076
There are 29 citations in total.

Details

Primary Language English
Subjects Rehabilitation
Journal Section Research Article
Authors

Emre Şenocak 0000-0003-3677-9813

Veysel Akduman 0000-0002-4981-6049

Emel Mete 0000-0002-6021-6466

Tuğba Eyigürbüz 0000-0003-3543-4290

Adem Aktürk 0000-0002-2487-5720

Submission Date March 5, 2025
Acceptance Date August 21, 2025
Publication Date January 9, 2026
Published in Issue Year 2026 Volume: 14 Issue: 1

Cite

APA Şenocak, E., Akduman, V., Mete, E., … Eyigürbüz, T. (2026). ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE. Ergoterapi Ve Rehabilitasyon Dergisi, 14(1), 1-12. https://doi.org/10.30720/ered.1651972
AMA Şenocak E, Akduman V, Mete E, Eyigürbüz T, Aktürk A. ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE. Ergoterapi ve Rehabilitasyon Dergisi. January 2026;14(1):1-12. doi:10.30720/ered.1651972
Chicago Şenocak, Emre, Veysel Akduman, Emel Mete, Tuğba Eyigürbüz, and Adem Aktürk. “ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE”. Ergoterapi Ve Rehabilitasyon Dergisi 14, no. 1 (January 2026): 1-12. https://doi.org/10.30720/ered.1651972.
EndNote Şenocak E, Akduman V, Mete E, Eyigürbüz T, Aktürk A (January 1, 2026) ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE. Ergoterapi ve Rehabilitasyon Dergisi 14 1 1–12.
IEEE E. Şenocak, V. Akduman, E. Mete, T. Eyigürbüz, and A. Aktürk, “ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE”, Ergoterapi ve Rehabilitasyon Dergisi, vol. 14, no. 1, pp. 1–12, 2026, doi: 10.30720/ered.1651972.
ISNAD Şenocak, Emre et al. “ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE”. Ergoterapi ve Rehabilitasyon Dergisi 14/1 (January2026), 1-12. https://doi.org/10.30720/ered.1651972.
JAMA Şenocak E, Akduman V, Mete E, Eyigürbüz T, Aktürk A. ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE. Ergoterapi ve Rehabilitasyon Dergisi. 2026;14:1–12.
MLA Şenocak, Emre et al. “ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE”. Ergoterapi Ve Rehabilitasyon Dergisi, vol. 14, no. 1, 2026, pp. 1-12, doi:10.30720/ered.1651972.
Vancouver Şenocak E, Akduman V, Mete E, Eyigürbüz T, Aktürk A. ASSESSING FALLS IN PARKINSON’S DISEASE: THE TURKISH ADAPTATION OF THE PARKINSON DISEASE FALLS QUESTIONNAIRE. Ergoterapi ve Rehabilitasyon Dergisi. 2026;14(1):1-12.

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