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J Neurol. 2016 Jan;263(1):133-9. doi: 10.1007/s00415-015-7950-x. Epub 2015 Nov 3.

Can postural instability tests improve the prediction of future falls in people with Parkinson's disease beyond knowing existing fall history?

Author information

1
Liberty Mutual Research Institute for Safety, 71 Frankland Rd, Hopkinton, MA, 01748, USA. jesse.jacobs@libertymutual.com.
2
Department of Rehabilitation and Movement Science, University of Vermont, 305 Rowell Building, 106 Carrigan Drive, Burlington, VT, 05405, USA. jesse.jacobs@libertymutual.com.
3
Program in Physical Therapy, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
4
Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.
5
Department of Anatomy and Neurobiology, Washington University School of Medicine in St. Louis, St. Louis, MO, 63110, USA.

Abstract

This study sought to determine whether the backward-stepping Push and Release (P&R) Test and the Pull Test, or comprehensive batteries of postural instability (the Mini-BESTest and Brief-BESTest), significantly improve the prediction of future falls beyond knowing a person's baseline fall history. Complete data were available for 43 of 80 participants with PD. At baseline, participants completed the BESTest (which was scored for all versions and includes the P&R Test), the Unified PD Rating Scale (UPDRS) motor section (which includes the Pull Test), and the participants' reported falls experienced in the previous 6 months. Participants were classified as recurrent fallers if they reported more than one fall in the 12 months subsequent to baseline. Stepwise logistic regressions determined whether the P&R Test, Pull Test, Brief-BESTest, Mini-BESTest, or UPDRS motor score improved predictions of recurrent fallers independent of baseline fall-group status. Independently, all assessments significantly predicted future recurrent fallers, but only the Mini-BESTest and Brief-BESTest significantly improved predictions of future recurrent fallers independent of baseline fall-group status. The results suggest that, although single tests of reactive postural control do not offer significant predictive benefit, predictions of future recurrent fallers with PD do benefit from a balance examination in addition to knowing whether an individual has a recent history of falls.

KEYWORDS:

BESTest; Falls; Parkinson’s disease; Pull Test; Push and Release Test

PMID:
26530511
DOI:
10.1007/s00415-015-7950-x
[Indexed for MEDLINE]
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