Journal ArticleDOI
Prospective assessment of falls in Parkinson's disease
Bastiaan R. Bloem,Yvette A. M. Grimbergen,Monique Cramer,Mirjam D Willemsen,Aeilko H. Zwinderman +4 more
TLDR
It is concluded that falls are common and disabling, even in relatively early stage PD.Abstract:
We studied prospectively the epidemiology, clinical impact and prediction of falls in 59 moderately affected patients with Parkinson's disease (PD) (mean UPDRS motor score 31.5; mean age 61 years) and 55 controls (mean age 60 years). At baseline, balance and gait were evaluated extensively. The retropulsion test (response to sudden shoulder pull) was executed first unexpectedly and five more times following prior warning. All persons used standardised scoring forms to document their falls during six months. Thirty patients (50.8 %) and eight controls (14.5%) fell at least once (relative risk [RR] 6.1; 95% confidence interval [CI] 2.5-15.1, p or = 2) falls occurred in 15 patients (25.4%), but in only two controls (RR 9.0; 95 % CI 2.0-41.7; p=0.001). Recurrent falls were more common among persons taking benzodiazepines (RR 5.0; 95% CI 1.6-15.5; p 100; 95% CI 3.1-585) and asking for prior falls (RR 5.0; 95% CI 1.2-20.9). We conclude that falls are common and disabling, even in relatively early stage PD. Recurrent fallers were best predicted by disease severity and presence of prior falls. Strategies to prevent falls in PD should particularly focus at intrinsic (patient-related) factors, such as minimising the use of benzodiazepines.read more
Citations
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Journal ArticleDOI
Postural Orientation and Equilibrium: What Do We Need to Know About Neural Control of Balance to Prevent Falls?
TL;DR: The effective rehabilitation of balance to improve mobility and to prevent falls requires a better understanding of the multiple mechanisms underlying postural control.
Journal ArticleDOI
Falls and freezing of gait in Parkinson's disease : a review of two interconnected, episodic phenomena
TL;DR: A review of the literature and the current state‐of‐the‐art suggests that clinicians should not feel deterred by the complex nature of falls and freezing of gait; a careful clinical approach may lead to an individually tailored treatment, which can offer at least partial relief for many affected patients.
Journal ArticleDOI
Gait dynamics, fractals and falls: finding meaning in the stride-to-stride fluctuations of human walking.
TL;DR: Support for the idea that gait dynamics has meaning has meaning and may be useful in providing insight into the neural control of locomotion and for enhancing functional assessment of aging, chronic disease, and their impact on mobility is discussed.
Journal ArticleDOI
Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study
TL;DR: Falls are a common problem in Parkinson's disease and some of the major risk factors are potentially modifiable, and there is a need for future studies to look at interventions to prevent falls.
Journal ArticleDOI
Gait dynamics in Parkinson’s disease: Common and distinct behavior among stride length, gait variability, and fractal-like scaling
TL;DR: This update highlights the idea that while stride length, gait variability, and fractal scaling of gait are all impaired in PD, distinct mechanisms likely contribute to and are responsible for the regulation of these disparate gait properties.
References
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