dr n. med. Magdalena Wójcik-Pędziwiatr, Department of Neurology, Jagiellonian University Medical College, 3 Botaniczna St, 31-503 Krakow, Poland, e-mail:
Neurol Neurochir Pol. 2013 Sep-Oct;47(5):423-30. doi: 10.5114/ninp.2013.38222.
Falls are common events in Parkinson disease (PD) but only a few prospective studies have focused on causes and consequences of falls in PD patients. The aim of the study was prospective analysis of direct causes and consequences of falls in PD patients in comparison to the control group.
One hundred PD patients and 55 age-matched controls were enrolled in the study. The diagnostic workup in all patients included neurological examination, Unified Parkinson's Disease Rating Scale, magnetic resonance imaging, electroencephalography, ultrasonography, otolaryngological, ophthalmological and autonomic function examination. During 12 months of follow-up, falls were registered in both groups, direct causes were classified according to the St. Louis and Olanow classification, and consequences were established.
Falls occurred in 54% of PD patients and in 18% of control subjects. Analysis of direct causes of falls revealed that sudden falls were the most common (31%), followed by episodes of freezing and festination (19.6%), neurological and sensory disturbances (mostly vertigo) (12%), environmental factors (12%), postural instability (11%), orthostatic hypotension (4%), and severe dyskinesia (3.6%); 6.19% of falls were unclassified; 22% of patients had the same etiology of subsequent falls. In PD patients, intrinsic factors were dominant, whereas in the control group intrinsic and extrinsic factors occurred with the same frequency. Every third fall intensified fear of walking. 34% of falls caused injuries; among them bruises of body parts other than the head were most frequent.
Intrinsic factors are the most common causes of falls in PD. Every third fall intensifies fear of walking and causes injuries.
跌倒在帕金森病（PD）中很常见，但只有少数前瞻性研究关注 PD 患者跌倒的原因和后果。本研究旨在前瞻性分析 PD 患者与对照组患者跌倒的直接原因和后果。
本研究纳入了 100 名 PD 患者和 55 名年龄匹配的对照者。所有患者的诊断评估均包括神经系统检查、统一帕金森病评定量表、磁共振成像、脑电图、超声、耳鼻喉科、眼科和自主功能检查。在 12 个月的随访期间，记录了两组患者的跌倒情况，根据圣路易斯和奥朗诺分类对跌倒的直接原因进行分类，并确定其后果。
PD 患者中有 54%发生跌倒，对照组中有 18%发生跌倒。对跌倒的直接原因进行分析发现，猝倒（31%）是最常见的跌倒原因，其次是冻结和慌张步态（19.6%）、神经和感觉障碍（主要为眩晕）（12%）、环境因素（12%）、姿势不稳（11%）、体位性低血压（4%）和严重运动障碍（3.6%）；6.19%的跌倒无法分类；22%的患者后续跌倒具有相同的病因。在 PD 患者中，内在因素占主导地位，而在对照组中，内在和外在因素的发生率相同。每三个跌倒就会加剧对行走的恐惧。34%的跌倒导致受伤；其中，身体除头部以外的部位淤青最为常见。
内在因素是 PD 患者跌倒的最常见原因。每三个跌倒就会加剧对行走的恐惧并导致受伤。
