Ettore Beghi1, Elisa Gervasoni2, Elisabetta Pupillo1, Elisa Bianchi1, Angelo Montesano2, Irene Aprile3, Michela Agostini4, Marco Rovaris2, Davide Cattaneo5. 1. IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy. 2. Larice Laboratory Centro IRCCS, Fondazione Don Gnocchi, Milano, Italy. 3. Centro IRCCS, Fondazione Don Gnocchi, Roma, Italy. 4. Laboratorio di Cinematica e Robotica, I.R.C.C.S. Fondazione Ospedale San Camillo, Venezia, Italy. 5. Larice Laboratory Centro IRCCS, Fondazione Don Gnocchi, Milano, Italy. Electronic address: dcattaneo@dongnocchi.it.
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.
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.
Authors: Alexandra Schättin; Stephan Häfliger; Alain Meyer; Barbara Früh; Sonja Böckler; Yannic Hungerbühler; Eling D de Bruin; Sebastian Frese; Regula Steinlin Egli; Ulrich Götz; René Bauer; Anna Lisa Martin-Niedecken Journal: JMIR Serious Games Date: 2021-05-07 Impact factor: 4.143