Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong, China.
J Neurol. 2009 Oct;256(10):1689-95. doi: 10.1007/s00415-009-5184-5. Epub 2009 May 28.
The present study aimed to examine whether fear of falling (FoF) could independently predict recurrent falls in people with Parkinson's disease (PD). Seventy patients with PD completed the study. Thirty-two patients had fallen at least once in the previous 12 months. Most of patients with PD had moderate disease severity (Hoehn and Yahr stage III). FoF was assessed by the activities-specific balance confidence (ABC) scale. PD specific motor and balance impairment was determined by Unified PD rating scale (UPDRS). Functional mobility was measured by timed-up-and-go (TUG) test. All patients were followed for 12 months by phone interview to register monthly fall incidence. Results of stepwise discriminant analysis showed that after adjusting for the fall history (F = 32.57, P < 0.001) and UPDRS motor score (F = 25.23, P < 0.001), ABC score (F = 18.84, P < 0.001) remained as a significant predictor of recurrent falls. We further established that a cut-off ABC score of 69 (i.e. 0-100, 0 indicates no confidence and 100 indicates full confidence) demonstrated the best sensitivity (93%) in predicting future falls in PD patients. The results indicate that those with an ABC score <69 at baseline had significantly higher risk of sustaining recurrent falls in the next 12 months. Findings of the present study highlight the importance of considering FoF during fall risk assessment in patients with PD.
本研究旨在探讨跌倒恐惧（Fear of Falling，FoF）是否可独立预测帕金森病（Parkinson's disease，PD）患者的复发性跌倒。70 名 PD 患者完成了这项研究。32 名患者在过去 12 个月中至少跌倒过一次。大多数 PD 患者的疾病严重程度为中度（Hoehn 和 Yahr 分期 III 期）。FoF 通过活动特异性平衡信心（Activities-specific Balance Confidence，ABC）量表评估。PD 特定的运动和平衡障碍由统一 PD 评定量表（Unified Parkinson's Disease Rating Scale，UPDRS）确定。功能性移动性通过计时起立行走（Timed-Up-and-Go，TUG）测试测量。所有患者在 12 个月内通过电话访谈进行随访，以登记每月跌倒发生率。逐步判别分析的结果表明，在调整跌倒史（F = 32.57，P < 0.001）和 UPDRS 运动评分（F = 25.23，P < 0.001）后，ABC 评分（F = 18.84，P < 0.001）仍然是复发性跌倒的重要预测因素。我们进一步确定，ABC 评分 <69（即 0-100，0 表示无信心，100 表示完全有信心）的截断值在预测 PD 患者未来跌倒方面具有最佳的敏感性（93%）。结果表明，基线时 ABC 评分 <69 的患者在接下来的 12 个月内再次发生跌倒的风险显著更高。本研究的结果强调了在 PD 患者跌倒风险评估中考虑 FoF 的重要性。
