[Posture and gait disorders and the incidence of falling in patients with Parkinson].
BACKGROUND
Although falls are one of the main causes of morbidity and mortality in patients with Parkinson's disease, studies about its incidence and predicting factors are scarce.


METHODS
Our study involved 25 patients with PD (15 males and 10 females; age: 75.8 +/- 6.5 years). A closed survey was used to determine a retrospective record of falls during the last year. An analysis was performed to examine whether there was a relationship with Hoehn and Yahr staging, the score on the Up and Go scale or the Barthel index and with possible risk factors for falls.


RESULTS
All the patients had suffered falls at some time over the last year (mean number of falls: 6.5 +/- 3.8). 56% of the falls happened during the phases of the day when patient mobility was at its highest. A significant correlation was found between the number of falls and the Hoehn and Yahr and the Up and Go scores. The number of falls was significantly higher in patients with loss of postural reflexes, the need for help in order to walk, and blockage and festination phenomena. No association was found with fear of falling, visual alterations or postural lateralisation. Association with the Barthel index and dependence for activities of daily living reached almost significant levels.


CONCLUSIONS
Postural instability and disorders affecting gait appear to be the factors that give patients with PD a greater propensity to fall. Patients who present such alterations should be submitted to rehabilitation therapy aimed at preventing them from falling.
Cano-de la Cuerda
R
R
Unidad de Fisioterapia, Terapia Ocupacional y Medicina Física-Rehabilitación, Unidad de Patología Médica, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. rcuerda@hotmail.com
Macías-Jiménez
A I
AI
Cuadrado-Pérez
M L
ML
Miangolarra-Page
J C
JC
Morales-Cabezas
M
M
D000058:Accidental Falls; D000061:Accidents, Home; D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D010300:Parkinson Disease / Q000150:complications*; D011187:Posture; D012189:Retrospective Studies; D012307:Risk Factors