The relation between falls risk and movement variability in Parkinson's disease.

Falls are a major health concern for older adults with Parkinson's disease (PD). This study was designed to examine differences in falls risk and its relation to changes in the average and variability (i.e. intra-individual variability) of reaction time (RT), finger tapping, standing balance and walking between healthy older adults and persons with PD. Thirty-nine adults with PD (70.0 ± 8.1 years) and 29 healthy older adults (66.8 ± 10.4 years) participated in this study. Falls risk (using the physiological profile assessment), gait, RT, balance and tapping responses were assessed for all persons. Results demonstrated that individuals with PD exhibited a greater risk of falling coupled with a general slowing of motor function covering declines in walking, RT and finger tapping. In addition, the movement responses of the PD group were more variable than the healthy older adults. Correlation results revealed group differences with regards to the neuromotor measures which were significantly correlated with falls risk. For the PD group, gait measures were highly correlated with their falls risk while, for the healthy older adults, falls risk was linked to balance measures even though PD persons had increased sway. Overall, persons with PD were at greater falls risk, moved slower and with increased variability compared to the healthy older adults. Further, while there are some similarities between the two groups in terms of those measures related to falls risk, there were also several differences which highlight that persons with PD can have different risk factors for falling compared to healthy adults of similar age.

Drainage: 'prevention is better than cure'.

Excellent standards of cleanliness are more important for healthcare facilities than in virtually every other type of building, and well-managed drainage systems play a crucial part in this. business and commercial, utilities, public sector, and facilities management clients. Nick Reilly, director at UKDN Waterflow, discusses best practice in this area for healthcare estates managers.