title: Impact of Falls on Physical Activity in People with Parkinson's Disease.
abstract: BACKGROUND
  A complex relationship exists between motor impairment, physical activity (sedentary behavior, standing and ambulatory activity) and falls in people with Parkinson's disease (PD).
  
  
  OBJECTIVE
  To explore associations between recent fall history and the ability to retain an active lifestyle as determined by the volume, pattern and variability of physical activity in people with PD.
  
  
  METHODS
  Forty-eight participants with PD were recruited from the Norwegian ParkWest study. Body posture and ambulatory activity were monitored objectively over 7 days using the activPAL3 accelerometer. Clinical assessments included the Hoehn and Yahr stage, Unified Parkinson's Disease Rating Scale motor section and Falls Efficacy Scale-International. Structured interviews were performed to obtain information about demographics, fall history last 6 months, mobility and dementia.
  
  
  RESULTS
  Participants with a fall history (n = 20) spent more time sedentary and less time standing than non-falling participants (n = 28). There were no significant differences regarding pattern or variability of sedentary behavior, standing or ambulatory activity in falling versus non-falling participants. Confidence in being able to get up from floor contributed significantly to time spent in sedentary behavior and ambulatory activity in participants with fall history, whereas motor impairment was significantly associated with time spent in all facets of physical activity for non-falling participants.
  
  
  CONCLUSIONS
  Fall history in our PD cohort was associated with a more sedentary lifestyle, but not less ambulatory activity. More emphasis on improving the capacity to safely complete activities of daily living and increase confidence in getting up from floor may reduce sedentary behavior in people with PD.
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway.|Department of Physical Medicine and Rehabilitation, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Ylva Hivand
authors.initials: YH
authors.lastname: Hiorth
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Jan Petter
authors.initials: JP
authors.lastname: Larsen
authors.affiliation: Department of Research, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Lode
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Neurology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ole-Bjørn
authors.initials: OB
authors.lastname: Tysnes
authors.affiliation: Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Godfrey
authors.affiliation: Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Sue
authors.initials: S
authors.lastname: Lord
authors.affiliation: Institute of Neuroscience, Newcastle University Institute for Ageing, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
authors.affiliation: The Norwegian Centre for Movement Disorders, Stavanger University Hospital, Stavanger, Norway.|Department of Neurology, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Kenn Freddy
authors.initials: KF
authors.lastname: Pedersen
mesh_terms: D061725:Accelerometry; D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications*; D010865:Pilot Projects; D057185:Sedentary Behavior
keywords: Parkinson’s disease; accelerometer; ambulation; falls; physical activity; sedentary behavior