Department of Physical Therapy, Medical College of Georgia, Augusta, GA.
Department of Neurology, Medical College of Georgia, Augusta, GA.
Eur J Neurol. 2011 Feb;18(2):260-265. doi: 10.1111/j.1468-1331.2010.03115.x.
The Fahn's pull (or retropulsion) test is an item in the motor section of the Unified Parkinson's Disease Rating Scale, which is used almost exclusively to classify postural instability in Parkinson's disease (PD). However, the test is hard to standardize and is often performed incorrectly, making it hard to interpret. Moreover, it may not be safe to administer in patients who experience pain in the shoulders, neck, trunk and/or lower extremities. Identifying and grading postural instability in PD without requiring a physical challenge would not only be useful for the clinician but would assist patients and caregivers in its recognition. We propose the use of the rapid assessment of postural instability in Parkinson's disease (RAPID) questionnaire as a non-physical assessment tool.
We determined the associations between the pull test and items on a risk-assessment questionnaire that consisted of three parts: activities of daily living, fear of falling, and frequency of falling.
Significant correlations were found between the pull test and the predictor variables, which ranged between 0.51 and 0.56 whilst the correlations amongst the predictor variables ranged between 0.58 and 0.70. The three parts of the questionnaire, when used in combination, produced a 96% sensitivity in the classification of postural instability.
The RAPID questionnaire can be used as an adjunct to the pull test or solely if the pull test is contraindicated. It may also be possible to administer the questionnaire via the telephone or Internet. It is hoped that the rapid identification of postural instability would lead to fewer falls.
Fahn 的拉（或推）试验是统一帕金森病评定量表运动部分的一个项目，几乎专门用于对帕金森病（PD）的姿势不稳进行分类。然而，该试验难以标准化，并且经常执行不正确，因此难以解释。此外，对于肩部、颈部、躯干和/或下肢疼痛的患者，进行该试验可能不安全。如果不需要身体挑战就能够识别和分级 PD 中的姿势不稳，那么这不仅对临床医生有用，而且还能帮助患者及其护理人员识别它。我们建议使用快速帕金森病姿势不稳评估（RAPID）问卷作为非身体评估工具。
我们确定了拉试验与由三部分组成的风险评估问卷中的项目之间的关联：日常生活活动、跌倒恐惧和跌倒频率。
拉试验与预测变量之间存在显著相关性，范围在 0.51 到 0.56 之间，而预测变量之间的相关性在 0.58 到 0.70 之间。问卷的三个部分联合使用时，对姿势不稳的分类具有 96%的敏感性。
RAPID 问卷可以作为拉试验的辅助工具，如果拉试验禁忌，也可以单独使用。也可以通过电话或互联网来管理问卷。希望快速识别出姿势不稳，从而减少跌倒。
