Abstract
Objective
To compare the risk of falls and fall predictors in patients with Parkinson disease
(PD), multiple sclerosis (MS), and stroke using the same study design.
Design
Multicenter prospective cohort study.
Setting
Institutions for physical therapy and rehabilitation.
Participants
Patients (N=299) with PD (n=94), MS (n=111), and stroke (n=94) seen for rehabilitation.
Interventions
Not applicable.
Main Outcome Measures
Functional scales were applied to investigate balance, disability, daily performance,
self-confidence with balance, and social integration. Patients were followed for 6
months. Telephone interviews were organized at 2, 4, and 6 months to record falls
and fall-related injuries. Incidence ratios, Kaplan-Meier survival curves, and Cox
proportional hazards models were used.
Results
Of the 299 patients enrolled, 259 had complete follow-up. One hundred and twenty-two
patients (47.1%) fell at least once; 82 (31.7%) were recurrent fallers and 44 (17.0%)
suffered injuries; and 16%, 32%, and 40% fell at 2, 4, and 6 months. Risk of falls
was associated with disease type (PD, MS, and stroke in decreasing order) and confidence
with balance (Activities-specific Balance Confidence [ABC] scale). Recurrent fallers
were 7%, 15%, and 24% at 2, 4, and 6 months. The risk of recurrent falls was associated
with disease type, high educational level, and ABC score. Injured fallers were 3%,
8%, and 12% at 2, 4, and 6 months. The only predictor of falls with injuries was disease
type (PD).
Conclusions
PD, MS, and stroke carry a high risk of falls. Other predictors include perceived
balance confidence and high educational level.
Keywords
List of abbreviations:
ABC (Activities-specific Balance Confidence), BBS (Berg Balance Scale), CI (confidence interval), CIQ (Community Integration Questionnaire), DGI (Dynamic Gait Index), IADL (instrumental activities of daily living), IQR (interquartile range), MS (multiple sclerosis), PD (Parkinson disease)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 01, 2017
Footnotes
Disclosures: Beghi reports grants from UCB-Pharma, grants from Shire, grants from EISAI, personal fees from Viropharma, grants from the Italian Ministry of Health, grants from the European Union, grants from Fondazione Borgonovo, and grants from Associazione IDIC 15, outside the submitted work. Pupillo reports grants from the Italian Ministry of Health, during the conduct of the study; grants from European FP7; and other from Fondazione Stefano Borgonovo and other from Revalesio Corporation, outside the submitted work. Cattaneo reports personal fees from BIOGEN IDEC, from null, outside the submitted work. The other authors have nothing to disclose.
Identification
Copyright
© 2017 by the American Congress of Rehabilitation Medicine
