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Affiliation
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Department of Physical Therapy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil. |
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Abstract
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BACKGROUND: Falls in Parkinson Disease are a complex health problem, with multidimensional causes and consequences.
OBJECTIVES: To identify the fall predictors in individuals with Parkinson Disease and compare fallers and non-fallers considering their socio-demographic, anthropometric, clinical and functional status.
METHODS: A multicenter cross-sectional design was employed. Variables included: age, sex, body mass index, Parkinson Disease progression, levodopa dosage, activities limitation and motor impairments (Unified Parkinson's Disease Rating Scale- Activity of Daily Living/Motor), level of physical activity (Human Activity Profile), fear of falls (Falls Efficacy Scale-International-FES-I), freezing of gait (Freezing of Gait Questionnaire), gait speed (10 meters walk test), lower limb functional strength (Five Times Sit-to-Stand Test-), balance (Mini-Balance Evaluation Systems Test), mobility (Timed "Up & Go") anddual-task dynamic (Timed "Up & Go"- Dual Task). Seventeen potential predictors were identified. Logistic regression and ROC curve were applied.
RESULTS: Three-hundred and seventy individuals (44.87% fallers and 55.13% non-fallers) completed the study. Fallers presented worse performance in Unified Parkinson's Disease Rating Scale motor/Activity of Daily Living/Total, Falls Efficacy Scale-International, Freezing of Gait-Questionnaire, Mini-Balance Evaluation Systems Test, Human Activity Profile, Timed "Up & Go" and Timed "Up & Go"-Dual Task and the majority were inactive. The Mini-Balance Evaluation Systems Test Total was the main independent predictor of falls (OR = 0.92; p < 0.001; 95% CI = 0.89 to 0.95). For each one-unit increase in the Mini-Balance Evaluation Systems Test, there was an average reduction of 8% in the probability of being a faller. A cut-off point of 21.5/28 (AUC = 0.669, sensitivity 70.7% and specificity 55.1%) was determined.
CONCLUSION: Besides characterizing and comparing fallers and non- fallers, this study showed that the Mini-Balance Evaluation Systems Test was the strongest individual predictor of falls in individuals with PD, highlighting the importance of evaluating dynamic balance ability during fall risk assessment.
Copyright © 2019 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.
Language: en |