Predictors of future falls in Parkinson disease

Kerr, G. K., Worringham, C. J., Cole, M. H., Lacherez, P. F., Wood, J. M. and Silburn, P.A. (2010) Predictors of future falls in Parkinson disease. Neurology, 75 2: 116-124. doi:10.1212/WNL.0b013e3181e7b688

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Author Kerr, G. K.
Worringham, C. J.
Cole, M. H.
Lacherez, P. F.
Wood, J. M.
Silburn, P.A.
Title Predictors of future falls in Parkinson disease
Journal name Neurology   Check publisher's open access policy
ISSN 0028-3878
Publication date 2010-07-01
Sub-type Article (original research)
DOI 10.1212/WNL.0b013e3181e7b688
Volume 75
Issue 2
Start page 116
End page 124
Total pages 9
Place of publication Philadelphia, United States
Publisher Lippincott Williams & Wilkins
Language eng
Formatted abstract
Background: Falls are a major health and injury problem for people with Parkinson disease (PD).
Despite the severe consequences of falls, a major unresolved issue is the identification of factors
that predict the risk of falls in individual patients with PD. The primary aim of this study was to
prospectively determine an optimal combination of functional and disease-specific tests to predict
falls in individuals with PD.
Methods: A total of 101 people with early-stage PD undertook a battery of neurologic and functional.
tests in their optimally medicated state. The tests included Tinetti, Berg, Timed Up and Go,
Functional Reach, and the Physiological Profile Assessment of Falls Risk; the latter assessment
includes physiologic tests of visual function, proprioception, strength, cutaneous sensitivity, reaction
time, and postural sway. Falls were recorded prospectively over 6 months.
Results: Forty-eight percent of participants reported a fall and 24% more than 1 fall. In the multivariate
model, a combination of the Unified Parkinson’s Disease Rating Scale (UPDRS) total score,
total freezing of gait score, occurrence of symptomatic postural orthostasis, Tinetti total score,
and extent of postural sway in the anterior-posterior direction produced the best sensitivity
(78%) and specificity (84%) for predicting falls. From the UPDRS items, only the rapid alternating
task category was an independent predictor of falls. Reduced peripheral sensation and knee extension
strength in fallers contributed to increased postural instability
Conclusions: Falls are a significant problem in optimally medicated early-stage PD. A combination
of both disease-specific and balance- and mobility-related measures can accurately predict falls in individuals with PD.
© 2010 by AAN Enterprises, Inc.
Keyword Elderly-patients
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: UQ Centre for Clinical Research Publications
Official 2011 Collection
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Citation counts: TR Web of Science Citation Count  Cited 193 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 201 times in Scopus Article | Citations
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Created: Sun, 08 Aug 2010, 10:02:00 EST