Movement strategies used during fall-related activities by repeat fallers and nonrepeat fallers with Parkinson's Disease (PD) (abstract of paper presented at Society for Research in Rehabilitation, Manchester 2001)

Stack, E., Ashburn, A. and Jupp, K. (2002) Movement strategies used during fall-related activities by repeat fallers and nonrepeat fallers with Parkinson's Disease (PD) (abstract of paper presented at Society for Research in Rehabilitation, Manchester 2001). Clinical Rehabilitation, 16 (2), p.224.

Abstract

Movement strategies used during fall related activities by repeat fallers and nonrepeat fallers with Parkinson's disease (PD) E Stack, A Ashburn and K JuppBackground: Information about the movement strategies deployed by repeat fallers (RFs) during fall-related activities is limited. The aims of this study were to describe how people with PD naturally turn and reach and compare the movement strategies of RFs with those of nonrepeat fallers (NRFs).Method: Independently mobile people with PD living in the community were recruited through GPs. Their disease severity, self-assessed disability and fall history was assessed at home. How subjects turned, reached high and reached low whilst making a cup of tea was video-recorded and rated blind using a validated, reliable checklist. Results: Seventy-five subjects (48 men), median age 73 years and median Hoehn and Yahr grade III were recruited. Forty-three subjects were RFs: they had greater disease severity and self-assessed disability than NRFs. Falls reported had occurred most frequently when walking (41%) or turning (17%). When turning, forwards stepping (33%) or sideways stepping (32%) movements were common, a median of six steps was taken, 88% demonstrated reduced heel strike and 25% used support. When reaching, 75% of subjects used support, 82% aligned forwards and 69% stood with their feet parallel. RFs and NRFs moved in similar ways, but RFs had a significantly smaller base width between their feet prior to moving (p < 0.001). Increased disease severity was linked with a high number of turning steps and observed instability.Conclusion: Surprisingly, the RFs were not distinguishable from NRFs by the way they moved during common fall-related activities. Rather, the small base area and apparent instability during functional activity should be targeted for intervention.

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