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Citation
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Beghi E, Gervasoni E, Pupillo E, Bianchi E, Montesano A, Aprile I, Agostini M, Rovaris M, Cattaneo D. Arch. Phys. Med. Rehabil. 2018; 99(4): 641-651. |
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Abstract
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OBJECTIVE: To compare the risk of falls and fall predictors in patients with Parkinson's disease (PD), multiple sclerosis (MS) and stroke using the same study design.
DESIGN: Multicenter prospective cohort study. SETTING: Three [masked] institutions for physical therapy and rehabilitation. PARTICIPANTS: Patients with PD, MS and stroke seen for rehabilitation. MAIN OUTCOME MEASURES: Functional scales were applied to investigate balance, disability, daily performance, self-confidence with balance, and social integration. Patients were followed for 6 months. Telephone interviews were organized at 2, 4 and 6 months to record falls and fall-related injuries. Incidence ratios, Kaplan-Meier survival curves and Cox proportional hazards models were used.
RESULTS: 299 patients (MS 111, PD and stroke 94 each) were enrolled and 259 had complete follow-up. One hundred and twenty-two (47.1%) fell at least once; 82 (31.7%) were recurrent fallers, 44 (17.0%) suffered injuries; 16%, 32% and 40% fell at 2, 4 and 6 months. Risk of falls was associated with disease type (PD, MS and stroke in decreasing order) and confidence with balance (ABC scale). Recurrent fallers were 7%, 15% and 24% at 2, 4 and 6 months. The risk of recurrent falls was associated with disease type, high educational level and the ABC score. Injured fallers were 3%, 8% and 12% at 2, 4 and 6 months. The only predictor of falls with injuries was disease type (PD).
CONCLUSIONS: PD, MS and stroke carry a high risk of falls. Other predictors include perceived balance confidence and high educational level.
Copyright © 2017. Published by Elsevier Inc.
Language: en |