Nicholas J Brandmeir1, Cheryl L Brandmeir2, Kristine Kuzma1, James McInerney1. 1. Department of Neurosurgery Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA. 2. Department of Therapy Services Penn State Milton S. Hershey Medical Center Hershey Pennsylvania USA.
Abstract
BACKGROUND: Postural instability (PI) and falls, major causes of morbidity in patients with PD, are often overlooked. DBS is a mainstay therapy for Parkinson's disease (PD) and has been purported to both worsen and improve PI. An effective PI evaluation that can predict fall risk in patients with PD presenting for DBS is needed. METHODS: Forty-nine consecutive patients with PD were enrolled. Self-reported falls were the gold standard. Tests evaluated were the Berg Balance Scale (BBS), Timed-Up-and-Go (TUG), Pull Test, and Biodex Balance System Sway Index on firm (SI-FIRM) and soft (SI-SOFT) surfaces. RESULTS: The best single tests for fall risk were the BBS and SI-FIRM, each with sensitivities of 79% and specificities of 60% and 65%, respectively. When the evaluation was combined into a composite measure requiring four positive tests out of five, the sensitivity was 72% and specificity was 80%. CONCLUSIONS: A simple, efficient outpatient physical therapy assessment is effective in diagnosing fall risk in patients with PD.
BACKGROUND: Postural instability (PI) and falls, major causes of morbidity in patients with PD, are often overlooked. DBS is a mainstay therapy for Parkinson's disease (PD) and has been purported to both worsen and improve PI. An effective PI evaluation that can predict fall risk in patients with PD presenting for DBS is needed. METHODS: Forty-nine consecutive patients with PD were enrolled. Self-reported falls were the gold standard. Tests evaluated were the Berg Balance Scale (BBS), Timed-Up-and-Go (TUG), Pull Test, and Biodex Balance System Sway Index on firm (SI-FIRM) and soft (SI-SOFT) surfaces. RESULTS: The best single tests for fall risk were the BBS and SI-FIRM, each with sensitivities of 79% and specificities of 60% and 65%, respectively. When the evaluation was combined into a composite measure requiring four positive tests out of five, the sensitivity was 72% and specificity was 80%. CONCLUSIONS: A simple, efficient outpatient physical therapy assessment is effective in diagnosing fall risk in patients with PD.
Authors: M Jöbges; G Heuschkel; C Pretzel; C Illhardt; C Renner; H Hummelsheim Journal: J Neurol Neurosurg Psychiatry Date: 2004-12 Impact factor: 10.154
Authors: Daniela Navratilova; Alois Krobot; Pavel Otruba; Martin Nevrly; David Krahulik; Petr Kolar; Barbora Kolarova; Michaela Kaiserova; Katerina Mensikova; Miroslav Vastik; Sandra Kurcova; Petr Kanovsky Journal: Front Neurosci Date: 2020-08-14 Impact factor: 4.677