Clinical and physiological assessments for elucidating falls risk in Parkinson's disease
Identifieur interne : 002402 ( Main/Exploration ); précédent : 002401; suivant : 002403Clinical and physiological assessments for elucidating falls risk in Parkinson's disease
Auteurs : Mark D. Latt [Australie] ; Stephen R. Lord [Australie] ; John G. L. Morris [Australie] ; Victor S. C. Fung [Australie]Source :
- Movement Disorders [ 0885-3185 ] ; 2009-07-15.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Congélation.
English descriptors
- KwdEn :
- Accidental Falls (prevention & control), Aged, Analysis of Variance, Blood Pressure (physiology), Chi-Square Distribution, Cognitive disorder, Female, Follow-Up Studies, Freezing, Humans, Male, Middle Aged, Nervous system diseases, Neurologic Examination, Neuropsychological Tests, Parkinson Disease (physiopathology), Parkinson Disease (therapy), Parkinson disease, Parkinson's disease, Predictive Value of Tests, Reaction Time (physiology), Risk Assessment (methods), Risk Factors, Risk factor, Sex Factors, Strength, accidental falls, balance, cognitive impairment, freezing of gait, muscle strength.
- MESH :
- methods : Risk Assessment.
- physiology : Blood Pressure, Reaction Time.
- physiopathology : Parkinson Disease.
- prevention & control : Accidental Falls.
- therapy : Parkinson Disease.
- Aged, Analysis of Variance, Chi-Square Distribution, Female, Follow-Up Studies, Humans, Male, Middle Aged, Neurologic Examination, Neuropsychological Tests, Predictive Value of Tests, Risk Factors, Sex Factors.
Abstract
The study aims were to devise (1) a fall risk screen for people with PD using routine clinical measures and (2) an explanatory (physiological) fall risk assessment for guiding fall prevention interventions. One hundred thirteen people with PD (age 66 ± 95% CI 1.6 years) underwent clinical assessments and quantitative tests of sway, gait, strength, reaction time, and lower limb sensation. Participants were then followed up for 12 months to determine fall incidence. In the follow‐up year, 51 participants (45%) fell one or more times whereas 62 participants (55%) did not fall. Multivariate analyses of routine clinical measures revealed that a fall in the past year, abnormal axial posture, cognitive impairment, and freezing of gait were independent risk factors for falls and predicted 38/51 fallers (75%) and 45/62 non‐fallers (73%). A multivariate model combining clinical and physiological measures that elucidate the pathophysiology of falls identified abnormal posture, freezing of gait, frontal impairment, poor leaning balance, and leg weakness as independent risk factors. This model correctly classified 39/51 fallers (77%) and 51/62 non‐fallers (82%). Patients with PD at risk of falls can be identified accurately with routine clinical assessments and quantitative physiological tests. Many of the risk factors identified are amenable to targeted intervention. © 2009 Movement Disorder Society
Url:
DOI: 10.1002/mds.22561
Affiliations:
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Morris</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Neurology, Westmead Hospital, Sydney, New South Wales</wicri:regionArea><wicri:noRegion>New South Wales</wicri:noRegion></affiliation></author><author><name sortKey="Fung, Victor S C" sort="Fung, Victor S C" uniqKey="Fung V" first="Victor S. C." last="Fung">Victor S. C. Fung</name><affiliation wicri:level="1"><country xml:lang="fr">Australie</country><wicri:regionArea>Department of Neurology, Westmead Hospital, Sydney, New South Wales</wicri:regionArea><wicri:noRegion>New South Wales</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="sub">Official Journal of the Movement Disorder Society</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2009-07-15">2009-07-15</date><biblScope unit="vol">24</biblScope><biblScope unit="issue">9</biblScope><biblScope unit="page" from="1280">1280</biblScope><biblScope unit="page" to="1289">1289</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">C7F838555BD8188320EB81FF0D0EF33CF0CF177C</idno><idno type="DOI">10.1002/mds.22561</idno><idno type="ArticleID">MDS22561</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Accidental Falls (prevention & control)</term><term>Aged</term><term>Analysis of Variance</term><term>Blood Pressure (physiology)</term><term>Chi-Square Distribution</term><term>Cognitive disorder</term><term>Female</term><term>Follow-Up Studies</term><term>Freezing</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Nervous system diseases</term><term>Neurologic Examination</term><term>Neuropsychological Tests</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (therapy)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Predictive Value of Tests</term><term>Reaction Time (physiology)</term><term>Risk Assessment (methods)</term><term>Risk Factors</term><term>Risk factor</term><term>Sex Factors</term><term>Strength</term><term>accidental falls</term><term>balance</term><term>cognitive impairment</term><term>freezing of gait</term><term>muscle strength</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Risk Assessment</term></keywords><keywords scheme="MESH" qualifier="physiology" xml:lang="en"><term>Blood Pressure</term><term>Reaction Time</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="prevention & control" xml:lang="en"><term>Accidental Falls</term></keywords><keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Analysis of Variance</term><term>Chi-Square Distribution</term><term>Female</term><term>Follow-Up Studies</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Neurologic Examination</term><term>Neuropsychological Tests</term><term>Predictive Value of Tests</term><term>Risk Factors</term><term>Sex Factors</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Congélation</term><term>Facteur risque</term><term>Maladie de Parkinson</term><term>Pathologie du système nerveux</term><term>Résistance mécanique</term><term>Trouble cognitif</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Congélation</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The study aims were to devise (1) a fall risk screen for people with PD using routine clinical measures and (2) an explanatory (physiological) fall risk assessment for guiding fall prevention interventions. One hundred thirteen people with PD (age 66 ± 95% CI 1.6 years) underwent clinical assessments and quantitative tests of sway, gait, strength, reaction time, and lower limb sensation. Participants were then followed up for 12 months to determine fall incidence. In the follow‐up year, 51 participants (45%) fell one or more times whereas 62 participants (55%) did not fall. Multivariate analyses of routine clinical measures revealed that a fall in the past year, abnormal axial posture, cognitive impairment, and freezing of gait were independent risk factors for falls and predicted 38/51 fallers (75%) and 45/62 non‐fallers (73%). A multivariate model combining clinical and physiological measures that elucidate the pathophysiology of falls identified abnormal posture, freezing of gait, frontal impairment, poor leaning balance, and leg weakness as independent risk factors. This model correctly classified 39/51 fallers (77%) and 51/62 non‐fallers (82%). Patients with PD at risk of falls can be identified accurately with routine clinical assessments and quantitative physiological tests. Many of the risk factors identified are amenable to targeted intervention. © 2009 Movement Disorder Society</div></front></TEI><affiliations><list><country><li>Australie</li></country></list><tree><country name="Australie"><noRegion><name sortKey="Latt, Mark D" sort="Latt, Mark D" uniqKey="Latt M" first="Mark D." last="Latt">Mark D. Latt</name></noRegion><name sortKey="Fung, Victor S C" sort="Fung, Victor S C" uniqKey="Fung V" first="Victor S. C." last="Fung">Victor S. C. Fung</name><name sortKey="Lord, Stephen R" sort="Lord, Stephen R" uniqKey="Lord S" first="Stephen R." last="Lord">Stephen R. Lord</name><name sortKey="Morris, John G L" sort="Morris, John G L" uniqKey="Morris J" first="John G. L." last="Morris">John G. L. Morris</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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