|
First author
year
study aim | Participant numbera
Tested ON or OFF | Disease severity | Reporting period | Classification of participants | Number per falls classification | Variables examined | Analyses | Results |
|
Allcock et al.
2009 [15]
Determine whether measures of attention were associated with falls
|
164
(176)
OFF
| Unclear
| 12 months
| 0 falls
1 fall
>1 fall
| 61 (37%)
32 (20%)
71 (43%)
| Cognitive impairment
Demographics
Disease severity
Fall history
Nonmotor impairments
PD medications
Other medications | Negative binomial regression | Significant explanatory variables explaining fall frequency
(i) Disease severity (UPDRS)
(ii) Dopamine agonists
(iii) Cognitive impairment
(a) Power of attention
(b) Cognitive reaction time
(c) Reaction time variability
(iv) Fall history |
|
Bloem et al.
2001 [2]
Identify risk factors associated with falls and prediction of falls, particularly in relation to balance and gait |
59
(61)
ON
|
Mild-moderately severe
|
6 months
|
0-1 fall
>1 fall
|
44 (75%)
15 (25%)
| Activities of daily living
Demographics
Disease duration
Disease severity
Fall history
Fear of falling
Medications
Mobility and use of aids
Motor impairments
Multiple task performance | Stepwise forward logistic regression | Recurrent fallers best predicted by the following
(i) Disease severity (H&Y)
(ii) Fall history |
|
Camicioli and Majumdar 2010 [23]
Identify risk factors associated with falls, with a focus on cognitive impairment |
52
(52)
ON
|
Mild-moderate
|
12 months
|
≥1 fall
>1 fall
|
21 (40%)
15 (29%)
| Cognitive impairment
Demographics
Disease severity
Fall history
Fear of falling
Gait parameters
Motor impairments
Nonmotor impairments
PD medications | Univariate analysis | Factors associated with an increased risk of recurrent falls
(i) Cognitive impairment (CCDRSum)
(ii) Fall history
(iii) Disease severity (H&Y)
(iv) Freezing (UPDRS item) |
|
Foreman et al.
2011 [28]
Examine the Functional
Gait Assessment, the pull test, and the timed up and go and their relation to falls |
36
(36)
OFF and ON
| Mild-moderately severe
| ≥6 months
| 0-1 fall
>1 fall
| 14 (39%)
22 (61%)
| Demographics
Disease duration
Disease severity
Mobility
Motor impairments | Receiver operating characteristic curve | Interpretation of performance when OFF provided more accurate prediction of fall status than the ON condition |
Between-group comparisons
| Compared to single + nonfallers, recurrent fallers had the following
(i) Worse Functional Gait Assessment scores when ON and when OFF
(ii) Slower timed up and go when OFF |
|
Mak and Pang 2009 [33]
Examine whether
fear of falling could independently predict recurrent
falls
|
70
(72)
ON
| Moderate
| 12 months
| 0-1 fall
>1 fall
| 55 (79%)
15 (21%)
| Demographics
Disease duration
Disease severity
Fall history
Fear of falling
Medications
Mobility
Nonmotor impairments |
Stepwise discriminant analysis | For predicting future recurrent fallers
(i) Fall history strongest predictor
(ii) UPDRS motor score and fear of falling (ABC) remain significant after adjusting for fall history
|
|
Receiver operating characteristic curve | For identifying recurrent fallers
(i) ABC cut-off score of 69 (sensitivity 93%, specificity 67%) and UPDRS motor score of 32 (sensitivity 47%, specificity 94%) provide the best combination |
|
Between-group comparisons | Compared to single + nonfallers, recurrent fallers had the following
(i) Increased disease severity (H&Y)
(ii) Higher UPDRS motor scores
(iii) Increased fear of falling |
|
Mak and Pang 2010 [18]
Compare fall characteristics between single and recurrent fallers |
72
(74)
ON
|
Mild-moderate
|
12 months
|
0 falls
1 fall
>1 fall
|
47 (65%)
12 (17%)
13 (18%)
| 21 variables including
Anthropometrics
Demographics
Disease duration
Disease severity
Fall history
Fear of falling
Habitual physical activity
Mobility and use of aids
Motor impairments
Nonmotor impairments
PD medications | Between-group comparisons | Compared to single fallers, recurrent fallers had the following
(i) More previous falls
(ii) Increased PD motor impairments (UPDRS)
(iii) Reduced walking capacity (6 MWD)
(iv) Increased use of walking aids
(v) Reduced speed of sit-to-stand
(vi) Increased fear of falling (ABC)
(vii) A higher proportion of falls occurring indoors at home as opposed to outdoors |
|
Matinolli et al.
2011 [34]
Identify balance and
mobility related risk factors for recurrent falling
|
125
(125)
ON
| Mild-moderate
| 24 months
| 0-1 fall
>1 fall
0 falls
1 fall
2–5 falls
6–10 falls
11–100 falls
>208 falls | 66 (53%)
59 (47%)
46 (37%)
20 (16%)
22 (17%)
16 (13%)
15 (12%)
6 (5%) | Comorbidities
Cognitive impairment
Demographics
Disease severity
Fall history
Fear of falling
Habitual physical activity
Mobility and use of aids
Motor impairments
Nonmotor impairments
Other medications
PD medications |
Forward stepwise regression | Significant risk factors in the final multivariable model predicting recurrent falls
(i) Fall history
(ii) Disease severity (UPDRS II) |
Between-group comparisons
| Compared to single + nonfallers, recurrent fallers had the following
(i) Longer disease duration
(ii) Increased disease severity (H&Y and UPDRS ADL score, motor score and total)
(iii) Presence of freezing of gait
(iv) More falls unrelated to freezing of gait (UPDRS item 13)
(v) Experienced recent falls
(vi) Higher levodopa dose
(vii) Decreased physical activity
(viii) Reduced mobility (slowed walking speed and TUG)
(ix) Increased use of walking aids
(x) Increased postural sway |
|
