scholarly journals Recurrent Falls in Parkinson’s Disease: A Systematic Review

2013 ◽  
Vol 2013 ◽  
pp. 1-16 ◽  
Author(s):  
Natalie E. Allen ◽  
Allison K. Schwarzel ◽  
Colleen G. Canning
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fear Of Falling ◽  
Freezing Of Gait ◽  
Motor Impairment ◽  
Journal Articles ◽  
Factors Associated ◽  
Recurrent Falls ◽  
Wide Range ◽  
Reduced Physical Activity

Most people with Parkinson’s disease (PD) fall and many experience recurrent falls. The aim of this review was to examine the scope of recurrent falls and to identify factors associated with recurrent fallers. A database search for journal articles which reported prospectively collected information concerning recurrent falls in people with PD identified 22 studies. In these studies, 60.5% (range 35 to 90%) of participants reported at least one fall, with 39% (range 18 to 65%) reporting recurrent falls. Recurrent fallers reported an average of 4.7 to 67.6 falls per person per year (overall average 20.8 falls). Factors associated with recurrent falls include: a positive fall history, increased disease severity and duration, increased motor impairment, treatment with dopamine agonists, increased levodopa dosage, cognitive impairment, fear of falling, freezing of gait, impaired mobility and reduced physical activity. The wide range in the frequency of recurrent falls experienced by people with PD suggests that it would be beneficial to classify recurrent fallers into sub-groups based on fall frequency. Given that there are several factors particularly associated with recurrent falls, fall management and prevention strategies specifically targeting recurrent fallers require urgent evaluation in order to inform clinical practice.

The association between freezing of gait, fear of falling and anxiety in Parkinson’s disease: a longitudinal analysis

2020 ◽  
Author(s):  
Ires Ghielen ◽  
Perrie Koene ◽  
Jos WR Twisk ◽  
Gert Kwakkel ◽  
Odile A van den Heuvel ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Multidisciplinary Approach ◽  
Fear Of Falling ◽  
Freezing Of Gait ◽  
Confounding Factors ◽  
Nonmotor Symptoms ◽  
Independent Variables ◽  
Complex Interactions ◽  
Disease Characteristics

Aim: We studied the longitudinal associations between freezing of gait (FoG), fear of falling (FoF) and anxiety, and how these associations are influenced by confounding factors. Materials & methods: We analyzed longitudinal motor and nonmotor measurements from 153 Parkinson’s disease patients. Possible confounding factors were divided into three subgroups: demographics, disease characteristics, medication use and adverse effects of medication. Results: All crude associations between FoG, FoF and anxiety were significant and remained so after adjusting for confounders. When analyzing FoF and anxiety together as independent variables, the association between FoG and FoF remained, and the association between FoG and anxiety diminished. Conclusion: We confirm the complex interactions between motor and nonmotor symptoms in Parkinson’s disease, and plead for a multidisciplinary approach.

scholarly journals Transcranial direct current stimulation (tDCS) in addition to walking training on walking, mobility, and reduction of falls in Parkinson’s disease: study protocol for a randomized clinical trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Lucas Rodrigues Nascimento ◽  
Ester Miyuki Nakamura-Palacios ◽  
Augusto Boening ◽  
Daniel Lyrio Cabral ◽  
Alessandra Swarowsky ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Fear Of Falling ◽  
Cortical Excitability ◽  
Freezing Of Gait ◽  
Step Length ◽  
Control Group ◽  
Direct Current Stimulation

Abstract Background Transcranial direct current stimulation (tDCS) has the potential to modulate cortical excitability and enhance the effects of walking training in people with Parkinson’s disease. This study will examine the efficacy of the addition of tDCS to a task-specific walking training to improve walking and mobility and to reduce falls in people with Parkinson’s disease. Methods This is a two-arm, prospectively registered, randomized trial with concealed allocation, blinded assessors, participants and therapists, and intention-to-treat analysis. Twenty-four individuals with Parkinson’s disease, categorized as slow or intermediate walkers (walking speeds ≤ 1.0 m/s), will be recruited. The experimental group will undertake a 30-min walking training associated with tDCS, for 4 weeks. The control group will undertake the same walking training, but with sham-tDCS. The primary outcome will be comfortable walking speed. Secondary outcomes will include walking step length, walking cadence, walking confidence, mobility, freezing of gait, fear of falling, and falls. Outcomes will be collected by a researcher blinded to group allocation at baseline (week 0), after intervention (week 4), and 1 month beyond intervention (week 8). Discussion tDCS associated with walking training may help improve walking of slow and intermediate walkers with Parkinson’s disease. If walking is enhanced, the benefits may be accompanied by better mobility and reduced fear of falling, and individuals may experience greater free-living physical activity at home and in the community. Trial registration Brazilian Registry of Clinical Trials (ReBEC) RBR-6bvnx6. Registered on September 23, 2019

Factors associated with freezing of gait in patients with Parkinson’s disease

2018 ◽  
Vol 40 (2) ◽  
pp. 293-298 ◽  
Author(s):  
Seong-Min Choi ◽  
Hyun-Jung Jung ◽  
Geum-Jin Yoon ◽  
Byeong C. Kim
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Factors Associated

Relationship of Falls and Fear of Falling to Activity Limitations and Physical Inactivity in Parkinson’s Disease

2015 ◽  
Vol 23 (2) ◽  
pp. 187-193 ◽  
Author(s):  
Mon S. Bryant ◽  
Diana H. Rintala ◽  
Jyh-Gong Hou ◽  
Elizabeth J. Protas
Keyword(s):  
Physical Activity ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fear Of Falling ◽  
Demographic Data ◽  
Motor Impairment ◽  
Design Methods ◽  
Lower Percentage ◽  
Activity Limitations ◽  
Cross Sectional

Aim:To investigate the relationships between falls, fear of falling, and activity limitations in individuals with Parkinson’s disease (PD).Design/methods:Cross-sectional study of individuals with mild to moderate PD (N = 83). Associations among demographic data, fall frequency, disease severity, motor impairment, ability to perform activities of daily living (ADL), Activities Balance Confidence Scale, Iowa Fatigue Scale, Comorbidity Index, and Physical Activity Scale for Elders were studied.Results:Frequent fallers had more ADL limitations than nonfallers (p < .001) and rare fallers (p = .004). Frequent fallers reported a lower percentage of ability to perform ADL than nonfallers (p = .003). Frequent fallers and rare fallers were less physically active than nonfallers (p = .015 and p = .040, respectively). Frequent fallers and rare fallers reported a higher level of fear of falling than nonfallers (p = .031 and p = .009, respectively).Conclusions:Falls and fear of falling were associated with more ADL limitations and less physical activity after adjusting for physical impairments.

Change in fear of falling in Parkinson's disease: a two-year prospective cohort study

2017 ◽  
Vol 31 (1) ◽  
pp. 13-20 ◽  
Author(s):  
Tatjana Gazibara ◽  
Darija Kisic Tepavcevic ◽  
Marina Svetel ◽  
Aleksandra Tomic ◽  
Iva Stankovic ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Fall Prevention ◽  
Rating Scale ◽  
Fear Of Falling ◽  
Daily Activities ◽  
First Year ◽  
Factors Associated ◽  
Disease Rating

ABSTRACTBackground:Fear of falling in Parkinson's disease (PD) has been suggested as predictor of future falling. The purpose of this study was to compare fear of falling score after two years of follow-up with those observed at baseline and to assess factors associated with change in fear of falling over time.Methods:A total of 120 consecutive persons with PD were recruited and followed for two years. Fear of falling was assessed by using the 10-item Falls Efficacy Scale (FES). Occurrence of falling was registered during the first year of follow-up.Results:After two years, the average FES score statistically significantly changed (p = 0.003) from 30.5 to 37.5 out of 100 (increase of 22.9%). We observed that median scores of all FES items, except for “Preparing a meal, not requiring carrying of heavy or hot objects” and “Personal grooming,” significantly increased after two-year follow-up. After accounting for age, gender, PD duration, levodopa dosage, Hoehn and Yayhr stage, Unified Parkinson's Disease Rating Scale score three, depression, anxiety, and falling, we observed that sustaining greater number of falls in the first year of follow-up was associated with higher increase in FES score after two years (odds ratio 3.08, 95% confidence interval 1.30–4.87).Conclusion:After two years of follow-up, we observed a decrease in confidence at performing nearly all basic daily activities. Fall prevention programs should be prioritized in management of PD.

scholarly journals Validation of the German Version of the New Freezing of Gait Questionnaire for People with Parkinson‘s Disease

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Jana Seuthe ◽  
Kristina Kuball ◽  
Ann-Kristin Hoffmann ◽  
Burkhard Weisser ◽  
Günther Deuschl ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Internal Consistency ◽  
Fear Of Falling ◽  
Freezing Of Gait ◽  
Cognitive State ◽  
German Version ◽  
Divergent Validity ◽  
Timed Up And Go ◽  
Convergent And Divergent Validity

Freezing of gait (FOG) in Parkinson’s disease (PD) is a highly disabling symptom which impacts quality of life. The New FOG Questionnaire (NFOG-Q) is the most commonly used tool worldwide to characterize FOG severity in PD. This study aims to provide a German translation of the NFOG-Q and to assess its validity in people with PD. The questionnaire was translated using forward-backward translation. Validity was tested in 57 PD patients with FOG via Cronbach’s alpha for internal consistency and Spearman correlations with several clinical measures to quantify disease severity, mobility, fall risk, and cognitive state for convergent and divergent validity. The German version of the NFOG-Q shows good internal consistency (Cα = 0.84). Furthermore, the NFOG-Q score was significantly correlated with the MDS-UPDRS III, H&Y stage, Timed Up and Go test, and the subjective fear of falling (FES-I). The lack of correlation with cognition (MoCA) points towards good divergent validity. This study provides a German version of the NFOG-Q which proved to be valid for the assessment of FOG severity in individuals with PD.

scholarly journals Effects of Gait Inducing Assist for Patients with Parkinson’s Disease on Double Support Phase During Gait

2020 ◽  
Vol 32 (4) ◽  
pp. 798-811
Author(s):  
Ai Higuchi ◽  
Junichiro Shiraishi ◽  
Yuichi Kurita ◽  
Tomohiro Shibata ◽  
◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Freezing Of Gait ◽  
Step Length ◽  
Motor Symptom ◽  
Elderly Subjects ◽  
Healthy Elderly ◽  
Wide Range ◽  
Healthy Elderly Subjects ◽  
Support Phase

Parkinson’s disease (PD) is a common progressive neurodegenerative disease that affects a wide range of motor and non-motor symptoms. Freezing of gait (FOG) is such a motor symptom of PD that frequently results in falling, and almost half of PD patients suffer from FOG. In this study, we investigated the effectiveness of a robotic assistance system called UPS-PD, which was developed to suppress FOG. The double limb support phase (DLS) in a 10-m straight-line walking task, the gait time and step counts were measured in five PD subjects. In addition, the safety of the UPS-PD in a healthy person was investigated using OpenSim, and the DLS parameters in four healthy elderly subjects were evaluated. In the experiment with the PD patients, the DLS parameters of two subjects showed an improvement. Furthermore, the step length of one subject and the step length and walking speed of the other subject were improved. Moreover, there were no problems in terms of instability of gait in both the PD patients. The UPS-PD did not adversely affect the gait of healthy elderly subjects and the walking of a healthy subject model in the simulation. Therefore, the UPS-PD is considered to be a useful device for improving walking in PD patients.

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