Munhoz Renato P, Teive Helio A
Movement Disorders Centre, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada.
Unidade de Desordens do Movimento, Serviço de Neurologia, Hospital de Clínicas, Universidade Federal do Paraná, Curitiba, PR, Brazil.
Arq Neuropsiquiatr. 2014 Aug;72(8):587-91. doi: 10.1590/0004-282x20140082. Epub 2014 Jul 4.
Postural instability (PI) and falls are major sources of disability in Parkinson's disease (PD). Our objectives were to evaluate the correlation between the pull-test (PT) scores and falls. Patients underwent a standardized data collection including demographic, clinical data, and the UPDRS scores for falls and the PT. Cases with scores >1 for falls were considered frequent fallers. 264 patients were included with mean age 67.6±10 years, mean age of onset 59.1±10.7 years. Comparison between PT scores versus the proportion of frequent fallers and the mean score of the UPDRS for falls showed that for each increase in the PT score, both parameters were significantly worse, with positive linear relationship. For any abnormal PT score, sensibility and negative predictive value were excellent; specificity and positive predictive value improved with worse PT scores. In conclusion, the PT provides important and reliable information regarding PI and the risk of falls in PD.
姿势不稳(PI)和跌倒在帕金森病(PD)中是导致残疾的主要原因。我们的目的是评估拉拽试验(PT)评分与跌倒之间的相关性。患者接受了标准化的数据收集,包括人口统计学、临床数据以及用于评估跌倒和PT的统一帕金森病评定量表(UPDRS)评分。跌倒评分>1分的病例被视为频繁跌倒者。纳入了264例患者,平均年龄67.6±10岁,平均发病年龄59.1±10.7岁。PT评分与频繁跌倒者比例以及跌倒的UPDRS平均评分之间的比较表明,PT评分每增加一分,这两个参数均显著变差,呈正线性关系。对于任何异常的PT评分,敏感性和阴性预测值都非常好;特异性和阳性预测值随着PT评分变差而提高。总之,PT提供了有关PD中姿势不稳和跌倒风险的重要且可靠的信息。