Prediction of instability in people with Parkinson’s disease - clinical balance and gait tests.
Author
Summary, in English
Objective: To explore whether clinical balance and gait tests can predict instability (falls and/or near falls) in people with Parkinson’s disease (PD).
Background: Current PD-studies suggest that multiple balance tests should be used in order to predict falls. However, few studies have included near falls when investigating falls prospectively as recommended.
Methods: The study included 74 people with PD (mean age and PD-duration, 69 and 4.9 years, respectively) visiting a neurological clinic during 2006-2010. Those >80 years of age, requiring support in standing or did not understand the instructions were excluded. Assessments included: the Berg Balance Scale (BBS, 0-56 points), Nutt’s Retropulsion test (NRT, dichotomized; 0=”normal”, 1=“abnormal”), tandem gait test (TG, dichotomized; 0=”normal”, 1= “abnormal”), 10-meter walk test (fast speed, m/s), and Timed Up & Go test (TUG, s). All assessments were conducted in the “on” condition. Participants then registered all falls and near falls by using a diary for six months.
Results: Mean score for UPDRS III was 14 (SD 7.5). Thirty-six participants (49 %) experienced ≥1 fall and/or near fall (“unstable” group), whereas 38 (51 %) had no incidents at all (“stable” group). Simple logistic regression analyses (controlling for age and gender) showed that (P≤0.05 in all instances) the NRT was the strongest predictor (OR=5.70) followed by TG (OR=3.45). Better BBS-scores (OR=0.88) and gait speed (OR=0.26) were associated with a decreased risk of instability. The longer time to perform TUG, the higher risk of being unstable (OR=1.14). When considering all five variables (i.e. tests) simultaneously only BBS was found significant (OR=0.91, P=0.04).
Conclusions: Clinical balance and gait tests can predict a future instability in people with PD. Further studies using larger samples are needed for firmer conclusions and to establish sensitivity/specificity and cut-off values for these tests.
Background: Current PD-studies suggest that multiple balance tests should be used in order to predict falls. However, few studies have included near falls when investigating falls prospectively as recommended.
Methods: The study included 74 people with PD (mean age and PD-duration, 69 and 4.9 years, respectively) visiting a neurological clinic during 2006-2010. Those >80 years of age, requiring support in standing or did not understand the instructions were excluded. Assessments included: the Berg Balance Scale (BBS, 0-56 points), Nutt’s Retropulsion test (NRT, dichotomized; 0=”normal”, 1=“abnormal”), tandem gait test (TG, dichotomized; 0=”normal”, 1= “abnormal”), 10-meter walk test (fast speed, m/s), and Timed Up & Go test (TUG, s). All assessments were conducted in the “on” condition. Participants then registered all falls and near falls by using a diary for six months.
Results: Mean score for UPDRS III was 14 (SD 7.5). Thirty-six participants (49 %) experienced ≥1 fall and/or near fall (“unstable” group), whereas 38 (51 %) had no incidents at all (“stable” group). Simple logistic regression analyses (controlling for age and gender) showed that (P≤0.05 in all instances) the NRT was the strongest predictor (OR=5.70) followed by TG (OR=3.45). Better BBS-scores (OR=0.88) and gait speed (OR=0.26) were associated with a decreased risk of instability. The longer time to perform TUG, the higher risk of being unstable (OR=1.14). When considering all five variables (i.e. tests) simultaneously only BBS was found significant (OR=0.91, P=0.04).
Conclusions: Clinical balance and gait tests can predict a future instability in people with PD. Further studies using larger samples are needed for firmer conclusions and to establish sensitivity/specificity and cut-off values for these tests.
Department/s
Publishing year
2013
Language
English
Pages
163-163
Publication/Series
[Publication information missing]
Volume
28(S1)
Document type
Conference paper: abstract
Topic
- Neurology
Conference name
International Congress of Parkinson's Disease and Movement Disorders, 2013
Conference date
2013-06-16 - 2013-06-20
Conference place
Sydney, Australia
Status
Published
Research group
- Clinical Memory Research
- Active and Healthy Ageing Research Group