Prediction of Falls in Subjects Suffering From Parkinson Disease, Multiple Sclerosis, and Stroke.
Arch Phys Med Rehabil
; 99(4): 641-651, 2018 04.
Article
en En
| MEDLINE
| ID: mdl-29102438
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 OUTCOMEMEASURES:
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.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Enfermedad de Parkinson
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Accidentes por Caídas
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Accidente Cerebrovascular
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Esclerosis Múltiple
Tipo de estudio:
Clinical_trials
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Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Arch Phys Med Rehabil
Año:
2018
Tipo del documento:
Article
País de afiliación:
Italia