Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
Parkinsons Dis. 2012;2012:901721. doi: 10.1155/2012/901721. Epub 2011 Oct 5.
The present study aimed to examine the contribution of gait impairment, postural stability and muscle weakness to the level of fear of falling in people with Parkinson's disease (PD). Fifty-seven community-dwelling individuals with PD completed the study. Fear of falling was assessed by the Activities-specific Balance Confidence (ABC) scale. Postural stability and gait difficulty were determined by the posture and gait subscores of the Unified Parkinson's Disease Rating Scale (UPDRS-PG). A Cybex dynamometer was used to measure isokinetic knee muscle strength. Individuals with PD achieved a mean ABC score of 73.6 ± 19.3. In the multiple regression analysis, after accounting for basic demographics, fall history and disease severity, the UPDRS-PG score remained independently associated with the ABC score, accounting for 13.4% of the variance (P < 0.001). The addition of knee muscle strength significantly improved the prediction model and accounted for an additional 7.3% of the variance in the ABC score (P < 0.05). This is the first study to demonstrate that the UPDRS-PG score and knee muscle strength are important and independent determinants of the level of fear of falling in individuals with PD. Improving balance, gait stability and knee muscle strength could be crucial in promoting balance confidence in the appropriately targeted PD population.
本研究旨在探讨步态障碍、姿势稳定性和肌肉力量对帕金森病（PD）患者跌倒恐惧程度的影响。57 名居住在社区的 PD 患者完成了本研究。跌倒恐惧程度通过活动特异性平衡信心量表（ABC 量表）进行评估。姿势稳定性和步态困难通过帕金森病评定量表（UPDRS-PG）的姿势和步态子量表进行评估。使用 Cybex 测力计测量等速膝关节肌肉力量。PD 患者的平均 ABC 评分为 73.6±19.3。在多元回归分析中，在考虑基本人口统计学、跌倒史和疾病严重程度后，UPDRS-PG 评分仍与 ABC 评分独立相关，解释了 13.4%的方差（P<0.001）。加入膝关节肌肉力量显著改善了预测模型，解释了 ABC 评分额外的 7.3%的方差（P<0.05）。这是第一项研究表明，UPDRS-PG 评分和膝关节肌肉力量是 PD 患者跌倒恐惧程度的重要且独立的决定因素。改善平衡、步态稳定性和膝关节肌肉力量可能对提高特定目标 PD 人群的平衡信心至关重要。
