Fear of falling is independently associated with recurrent falls in patients with Parkinson's disease: a 1-year prospective study
Fear of falling is independently associated with recurrent falls in patients with Parkinson's disease: a 1-year prospective study
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DOI：
10.1007/s00415-009-5184-5
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发表时间：
2009-10-01
影响因子：
6
通讯作者：
Pang, Marco Y. C.
中科院分区：
文献类型：
--
作者：
Mak, Margaret K. Y.;Pang, Marco Y. C.
本研究的目的是检查是否跌倒恐惧（FoF）可以独立预测帕金森病（PD）患者的复发性福尔斯。70例PD患者完成了研究。32名患者在过去12个月内至少跌倒过一次。大多数PD患者的疾病严重程度为中度（Hoehn和Yahr III期）。FoF通过特定活动平衡信心（ABC）量表进行评估。PD特异性运动和平衡障碍采用统一PD评定量表（UnifiedPD ratingscale，PDRS）评定。功能活动度通过计时起身行走（TUG）试验测量。所有患者随访12个月，通过电话访谈登记每月跌倒发生率。逐步判别分析结果显示，在校正跌倒史（F = 32.57，P < 0.001）和ABRS运动评分（F = 25.23，P < 0.001）后，ABC评分（F = 18.84，P < 0.001）仍是复发性福尔斯的显著预测因子。我们进一步确定，ABC评分69（即0-100，0表示无置信度，100表示完全置信度）的截止值证明了预测PD患者未来福尔斯的最佳灵敏度（93%）。结果表明，基线时ABC评分< 69的患者在接下来的12个月内持续复发性福尔斯的风险显著更高。本研究的结果强调了在PD患者跌倒风险评估过程中考虑FoF的重要性。
The present study aimed to examine whether fear of falling (FoF) could independently predict recurrent falls in people with Parkinson's disease (PD). Seventy patients with PD completed the study. Thirty-two patients had fallen at least once in the previous 12 months. Most of patients with PD had moderate disease severity (Hoehn and Yahr stage III). FoF was assessed by the activities-specific balance confidence (ABC) scale. PD specific motor and balance impairment was determined by Unified PD rating scale (UPDRS). Functional mobility was measured by timed-up-and-go (TUG) test. All patients were followed for 12 months by phone interview to register monthly fall incidence. Results of stepwise discriminant analysis showed that after adjusting for the fall history (F = 32.57, P < 0.001) and UPDRS motor score (F = 25.23, P < 0.001), ABC score (F = 18.84, P < 0.001) remained as a significant predictor of recurrent falls. We further established that a cut-off ABC score of 69 (i.e. 0-100, 0 indicates no confidence and 100 indicates full confidence) demonstrated the best sensitivity (93%) in predicting future falls in PD patients. The results indicate that those with an ABC score < 69 at baseline had significantly higher risk of sustaining recurrent falls in the next 12 months. Findings of the present study highlight the importance of considering FoF during fall risk assessment in patients with PD.