title: Clinical and posturographic correlates of falling in Parkinson's disease.
abstract: Various clinical tests and balance scales have been used to assess postural stability and the risk of falling in patients with idiopathic Parkinson's disease (IPD). Quantitative posturography allows a more objective assessment but the findings in previous studies have been inconsistent and few studies have investigated which posturographic measures correlate best with a history of falling. The purpose of this study was to determine the efficacy of clinical tests, balance scales, and stable-platform posturography in detecting postural instability and discriminating between fallers and non-fallers in a home-dwelling PD cohort. Forty-eight PD subjects (Hoehn & Yahr stage 1-3) and 17 age-matched controls had the following assessments: Activities-specific Balance Confidence scale, Berg Balance Scale, Unified Parkinson's Disease Rating Scale (UPDRS) (motor), pull-test, timed up-and-go, static posturography, and dynamic posturography to assess multidirectional leaning balance. Of the clinical assessments, all but the pull-test were closely correlated with a history of falling. Static posturography discriminated between PD fallers and controls but not between PD fallers and non-fallers, whereas dynamic posturography (reaction time, velocity, and target hit-time) also discriminated between fallers and non-fallers. Our findings suggest that this combination of clinical and posturographic measures would be useful in the prospective assessment of falls risk in PD patients. A further prospective study is now required to assess their predictive value. © 2013 Movement Disorder Society.
authors.affiliation: University of Western Australia, Nedlands, Western Australia, Australia.
authors.forename: Liam
authors.initials: L
authors.lastname: Johnson
authors.forename: Ian
authors.initials: I
authors.lastname: James
authors.forename: Julian
authors.initials: J
authors.lastname: Rodrigues
authors.forename: Rick
authors.initials: R
authors.lastname: Stell
authors.forename: Gary
authors.initials: G
authors.lastname: Thickbroom
authors.forename: Frank
authors.initials: F
authors.lastname: Mastaglia
mesh_terms: D000058:Accidental Falls; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D020233:Gait Disorders, Neurologic / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000150:complications*; D010808:Physical Examination; D004856:Postural Balance / Q000502:physiology*; D012044:Regression Analysis; D012720:Severity of Illness Index
keywords: Parkinson's disease; falls; postural instability; static and dynamic posturography