Clinical and Physiological Assessments for Elucidating Falls Risk in Parkinson's Disease
Identifieur interne : 000F46 ( PascalFrancis/Checkpoint ); précédent : 000F45; suivant : 000F47Clinical 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.
Descripteurs français
- Pascal (Inist)
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- topic : Congélation.
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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.
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Lord</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Prince of Wales Medical Research Institute, UNSW</s1><s2>Randwick, New South Wales</s2><s3>AUS</s3><sZ>2 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Randwick, New South Wales</wicri:noRegion></affiliation></author><author><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><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Westmead Hospital</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Sydney, 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"><inist:fA14 i1="03"><s1>Department of Neurology, Westmead Hospital</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Sydney, New South Wales</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">09-0349933</idno><date when="2009">2009</date><idno type="stanalyst">PASCAL 09-0349933 INIST</idno><idno type="RBID">Pascal:09-0349933</idno><idno type="wicri:Area/PascalFrancis/Corpus">000E33</idno><idno type="wicri:Area/PascalFrancis/Curation">001E86</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000F46</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Clinical and Physiological Assessments for Elucidating Falls Risk in Parkinson's Disease</title><author><name sortKey="Latt, Mark D" sort="Latt, Mark D" uniqKey="Latt M" first="Mark D." last="Latt">Mark D. Latt</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>Department of Aged Care, Royal Prince Alfred Hospital</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>1 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Sydney, New South Wales</wicri:noRegion></affiliation></author><author><name sortKey="Lord, Stephen R" sort="Lord, Stephen R" uniqKey="Lord S" first="Stephen R." last="Lord">Stephen R. Lord</name><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Prince of Wales Medical Research Institute, UNSW</s1><s2>Randwick, New South Wales</s2><s3>AUS</s3><sZ>2 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Randwick, New South Wales</wicri:noRegion></affiliation></author><author><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><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Department of Neurology, Westmead Hospital</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Sydney, 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"><inist:fA14 i1="03"><s1>Department of Neurology, Westmead Hospital</s1><s2>Sydney, New South Wales</s2><s3>AUS</s3><sZ>3 aut.</sZ><sZ>4 aut.</sZ></inist:fA14><country>Australie</country><wicri:noRegion>Sydney, New South Wales</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2009">2009</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cognitive disorder</term><term>Freezing</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Risk factor</term><term>Strength</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Maladie de Parkinson</term><term>Trouble cognitif</term><term>Pathologie du système nerveux</term><term>Facteur risque</term><term>Résistance mécanique</term><term>Congélation</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Congélation</term></keywords></textClass></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.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>24</s2></fA05><fA06><s2>9</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Clinical and Physiological Assessments for Elucidating Falls Risk in Parkinson's Disease</s1></fA08><fA11 i1="01" i2="1"><s1>LATT (Mark D.)</s1></fA11><fA11 i1="02" i2="1"><s1>LORD (Stephen R.)</s1></fA11><fA11 i1="03" i2="1"><s1>MORRIS (John G. L.)</s1></fA11><fA11 i1="04" i2="1"><s1>FUNG (Victor S. 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All rights reserved.</s1></fA44><fA45><s0>53 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>09-0349933</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>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. 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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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