Screening the occurrence of falls in a Parkinson’s disease population and retrospective analysis: a call for rehabilitation strategies at primary care setting

Abstract

Introduction: Falls are common in Parkinson’s disease (PD) increasing disability and morbidity. Rehabilitation programs (RP) and modification of risk factors can improve outcomes.   We aimed to characterize a PD population, its self-perceived balance and participation in RP and to find associations with falls occurrence.

Methods and Material Cross-sectional and retrospective study, comprising all PD patients of a family health unit. Two groups, fallers and non-fallers, were defined. Sociodemographic factors, participation on RP, Activities-specific Balance Confidence (ABC-16) scale score and other risk factors were recorded through questionnaire application by phone and complemented with clinical records. A comparative analysis was made between both groups, a cutoff value for ABC-16 scale score was determined and a logistic regression was performed to ascertain variables effect on the likelihood of falls occurrence.

Results: Thirty-four participants were eligible after exclusion criteria, of which 29,4% were physically active. In the last year, 41,2% had a RP and 18 reported at least one fall. Logistic regression model explained 70% of the variance in reported falls (p<0,005, sensibility 87%; specificity 94%): low ABC-16 score (OR: 11,4), non-participation in RP (OR: 15,3) and female gender (OR: 11,4) had increased likelihood of falling episodes in the last year. A cutoff value of 63 for ABC-16 score was determined.

Conclusions: The remote application of a questionnaire including ABC-16 scale may represent a screening tool to assess fall risk in PD. Female gender and non-participation on RP were associated with history of falling. These findings emphasize the need of fall prevention programs implementation.