Department of Neurology, Dartmouth Hitchcock Medical Center, Warren Alpert Medical School of Brown University, Hanover, NH, USA.
J Neurol. 2010 Jul;257(7):1124-8. doi: 10.1007/s00415-010-5475-x. Epub 2010 Feb 16.
The purpose of this study was to investigate the relationship between fear of falling and fall frequency among patients with idiopathic Parkinson's disease (PD). One hundred-two participants with idiopathic PD were interviewed and examined. Participants reported the number of falls they had experienced in the preceding 3 months. They completed a mini-mental state exam (MMSE) and the falls efficacy scale (FES) questionnaire. Disease severity was determined by clinical examination using the Hoehn-Yahr staging system. Excluding two outliers who fell more than once each day, the subjects fell an average of 1.2 times in a 3 month period. There was a positive correlation between the number of falls, freezing of gait and Hoehn-Yahr score, and a negative correlation with the MMSE. In a post-hoc analysis the participants were divided into four groups based on fall frequency. The outliers had the lowest FES scores on average, similar to the scores seen in the rare fallers group. This study suggests that many factors are associated with fear of falling, including fall frequency, disease severity, and mental status. In the present study, the patients who fell the most often did not report the most fear. The lack of fear of falling but frequent falls in this small subgroup may suggest that special techniques to instill suitable caution to prevent falls are necessary, or may make training of these patients impossible.
本研究旨在探讨特发性帕金森病（PD）患者跌倒恐惧与跌倒频率之间的关系。对 102 名特发性 PD 患者进行了访谈和检查。参与者报告了他们在过去 3 个月中经历的跌倒次数。他们完成了简易精神状态检查（MMSE）和跌倒效能量表（FES）问卷。使用 Hoehn-Yahr 分期系统进行临床检查来确定疾病严重程度。排除每天跌倒超过一次的两个离群值后，受试者在 3 个月内平均跌倒 1.2 次。跌倒次数、冻结步态和 Hoehn-Yahr 评分呈正相关，与 MMSE 呈负相关。在事后分析中，根据跌倒频率将参与者分为四组。离群值的 FES 评分平均最低，与罕见跌倒者组的评分相似。本研究表明，许多因素与跌倒恐惧有关，包括跌倒频率、疾病严重程度和精神状态。在本研究中，跌倒最多的患者并未报告最恐惧。这个小亚组中缺乏跌倒恐惧但经常跌倒可能表明需要特殊技术来灌输适当的谨慎以防止跌倒，或者可能使这些患者的训练变得不可能。
