title: What daily activities increase the risk of falling in Parkinson patients? An analysis of the utility of the ABC-16 scale.
abstract: BACKGROUND
  Although the strongest predictor of falling in Parkinson's disease is the number of falls in the preceding year, little information is available on what types of daily activities (ADLs) that are associated with a significant fall risk in this population.
  
  
  OBJECTIVE
  To determine balance confidence (FOF) in PD patients by utilizing the 16-item Activities-Specific Balance Confidence Scale (ABC-16), and identifying specific activities from this scale that are predictors of future falls.
  
  
  METHODS
  160 patients with PD, and 52 age-matched healthy controls completed the Thai-validated version of the ABC-16. The number of falls during the past month was obtained from both groups.
  
  
  RESULTS
  PD patients reported lower confidence in their ability to maintain balance during ADLs compared to controls (p<0.001) with the lowest confidence score being item 16 (walking on slippery sidewalks). A significant negative correlation was observed between the number of falls in the previous month, and a mean ABC-16 score (r=-0.387, p<0.001). Logistic regression analysis identified the strongest predictor of fall in PD patients was item 9 (getting in/out of car; OR=4.8), followed by item 6 (standing on chair to reach; OR=3.4), and item 3 (picking up slippers from floor; OR=2.6). All of these high-risk activities involve movement in the vertical orientation.
  
  
  CONCLUSIONS
  FOF was more common in PD patients than controls. In patients with postural instability and visual impairment, high-risk activities should be minimized, avoided, or performed only under supervision. It is recommended that fall prevention strategies include physical therapy interventions that are targeted at these activities.
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Chayanin
authors.initials: C
authors.lastname: Foongsathaporn
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Pattamon
authors.initials: P
authors.lastname: Panyakaew
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand.
authors.forename: Onanong
authors.initials: O
authors.lastname: Jitkritsadakul
authors.affiliation: Chulalongkorn Center of Excellence for Parkinson Disease & Related Disorders, Department of Medicine, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, 10330, Thailand; Department of Rehabilitation Medicine, Juntendo University, Tokyo, Japan. Electronic address: rbh@chulapd.org.
authors.forename: Roongroj
authors.initials: R
authors.lastname: Bhidayasiri
mesh_terms: D000058:Accidental Falls; D000203:Activities of Daily Living; D000368:Aged; D000704:Analysis of Variance; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000523:psychology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013223:Statistics as Topic; D016138:Walking / Q000502:physiology
keywords: Activities-Specific Balance Confidence Scale (ABC-16); Falls; Fear of falling; Getting out of car; Movement switching; Parkinson's disease