Article

In order to develop multifaceted fall prevention strategies for
people with Parkinson's disease (PD), greater understanding of the impact of
physical and cognitive performance on falls is required. OBJECTIVE: We aimed to
identify the relative contribution of a comprehensive range of physical and
cognitive risk factors to prospectively-measured falls in a large sample of
people with PD and develop an explanatory multivariate fall risk model in this group. METHODS MEASURES: of PD signs and symptoms, freezing of gait, balance,
mobility, proprioception, leg muscle strength, and cognition were collected on
205 community-dwelling people with PD. Falls were monitored prospectively for 6
months using falls diaries. RESULTS: A total of 120 participants (59%) fell
during follow-up. Freezing of gait (P < .001), dyskinesia (P = .02), impaired
anticipatory and reactive balance (P < .001), impaired cognition (P = .002),
reduced leg muscle strength (P = .006), and reduced proprioception (P = .04) were
significantly associated with future falls in univariate analyses. Freezing of
gait (risk ratio [RR] = 1.03, 95% confidence interval [CI] = 1.00-1.05, P = .02),
impaired anticipatory (RR = 1.01, 95% CI = 1.00-1.02, P = .03) and reactive (RR =
1.26, 95% CI = 1.01-1.58, P = .04) balance, and impaired orientation (RR = 1.28,
95% CI = 1.01-1.62, P = .04) maintained significant associations with falls in
multivariate analysis. CONCLUSION: The study findings elucidate important
physical and cognitive determinants of falls in people with PD and may assist in
developing efficacious fall prevention strategies for this high-risk group.

Langue : ANGLAIS