title: Fear of falling and falls in people with Parkinson's disease treated with deep brain stimulation in the subthalamic nuclei.
abstract: BACKGROUND
  No previous study prospectively investigated the effects of subthalamic deep brain stimulation on fear of falling (FOF) and falls.
  
  
  OBJECTIVE
  The aim was to prospectively explore whether FOF and fall rate were affected after STN stimulation in people with Parkinson's disease (PD).
  
  
  METHODS
  Twenty participants (mean age: 65, SD 6.4) were included. Falls and near falls were recorded (fall diary) during 3 months before and 1 year after surgery. FOF was evaluated using the Falls-Efficacy Scale, Swedish version, FES(S), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE).
  
  
  RESULTS
  After surgery, the FES(S) scores of complex activities improved (P=0.026), i.e. median 34 (q1-q3, 26-50) vs 43 (32-55). SAFFE scores also improved (P=0.007): median 25 (22-30) versus 22 (18-27). The rate of near falls decreased (P=0.014). Nine participants reported no near falls. For the remaining ten participants, the median near fall rate decreased from 6 (3-17) to 2 (1-8). The rate of falls showed no significant (P>0.3) difference.
  
  
  CONCLUSIONS
  After surgery, fewer activities were avoided owing to the risk of falling, and fall-related self-efficacy had improved during complex activities. The rate of near falls decreased. The results cannot support any change in fall rate.
authors.affiliation: Department of Health Sciences, Division of Physiotherapy, Lund University, Lund, Sweden. Maria_H.Nilsson@med.lu.se
authors.forename: M H
authors.initials: MH
authors.lastname: Nilsson
authors.forename: S
authors.initials: S
authors.lastname: Rehncrona
authors.forename: G-B
authors.initials: GB
authors.lastname: Jarnlo
mesh_terms: D000058:Accidental Falls / Q000401:mortality*; D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D001007:Anxiety / Q000209:etiology / Q000523:psychology* / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000379:methods; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D010300:Parkinson Disease / Q000523:psychology* / Q000628:therapy*; D017060:Patient Satisfaction; D011446:Prospective Studies; D012307:Risk Factors; D012648:Self Care / Q000523:psychology