Format

Send to

Choose Destination
Sci Rep. 2017 Jun 20;7(1):3921. doi: 10.1038/s41598-017-04302-7.

Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson's Disease.

Youn J1,2, Okuma Y3, Hwang M1,2, Kim D1,2, Cho JW4,5.

Author information

1
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2
Neuroscience Center, Samsung Medical Center, Seoul, Korea.
3
Department of Neurology, Juntendo University Shizuoka Hospital, Shizuoka, Japan.
4
Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. jinwhan.cho@samsung.com.
5
Neuroscience Center, Samsung Medical Center, Seoul, Korea. jinwhan.cho@samsung.com.

Abstract

Falls are a common and disabling symptom in patients with Parkinson's disease (PD). For prevention, it is important to understand the pathophysiology of falls in PD patients, but the predictors for the possible mechanisms underlying such falls have not been clearly elucidated. In this prospective observational study, we investigated the implications of falling direction to predict the mechanisms of recurrent falls in PD patients. We enrolled 62 recurrent fallers with PD and divided them into two groups according to the main falling directions: 45 PD fallers who fell forward (forward fallers), and 17 PD fallers who fell in the other directions (non-forward fallers). Although there was no difference in demographic data, parkinsonism, or frontal lobe function, forward fallers showed more severe falls and tended to fall during walking or turning, while non-forward fallers usually fell during sitting/standing or turning. Additionally, forward fallers revealed higher score on a freezing of gait (FOG) questionnaire. Logistic regression analysis demonstrated that FOG was associated with falling forward, while balance impairment, akinetic-rigid subtype, and neuropsychiatric symptoms were associated with falling into the other directions. Our results indicate that FOG and balance impairment are two major mechanisms for recurrent falling in PD patients, and falling direction is an important predictor for these mechanisms.

PMID:
28634343
PMCID:
PMC5478627
DOI:
10.1038/s41598-017-04302-7
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Nature Publishing Group Icon for PubMed Central
Loading ...
Support Center