Weaver Tyler B, Robinovitch Stephen N, Laing Andrew C, Yang Yijian
Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
Injury Biomechanics and Aging Laboratory, University of Waterloo, Waterloo, Ontario, Canada.
J Am Geriatr Soc. 2016 Jan;64(1):96-101. doi: 10.1111/jgs.13878.
To compare the fall characteristics of individuals with and without Parkinson's disease (PD) through the analysis of real-life falls captured on video.
Observational cohort study.
Two long-term care facilities in British Columbia, Canada.
Individuals living in long-term care (N=306; 16 with PD).
Falls captured on video and analyzed (N=906; 71 in participants with PD). Generalized estimating equation models were used to examine differences in fall characteristics between participants with and without PD.
Individuals with PD were 1.3 times as likely as those without PD to fall because of incorrect weight shifting (95% confidence interval (CI)=1.03-1.65). Secondary steps during the fall event were 1.5 times as likely to be short in individuals with PD as in those without (95% CI=1.23-1.78). Individuals with PD were also 1.6 times as likely to attempt to recover balance by reaching to grasp an external object (95% CI=1.13-2.15) and 5.0 times as likely to secure grasp of the object (95% CI=1.23-20.0).
Along with greater likelihood for individuals with PD to fall because of incorrect weight shifting, differences between groups were found in reactive stepping responses. This first detailed evidence of the characteristics of falls in PD should help to inform fall and injury prevention approaches for clinicians and rehabilitation professionals working with individuals with PD.
通过分析视频捕捉到的现实生活中的跌倒情况，比较帕金森病（PD）患者与非PD患者的跌倒特征。
观察性队列研究。
加拿大不列颠哥伦比亚省的两家长期护理机构。
居住在长期护理机构的个体（N = 306；16例患有PD）。
对视频捕捉到的跌倒情况进行分析（N = 906；PD患者中有71例）。使用广义估计方程模型来检验PD患者与非PD患者之间跌倒特征的差异。
由于体重转移不正确，PD患者跌倒的可能性是非PD患者的1.3倍（95%置信区间（CI）= 1.03 - 1.65）。在跌倒事件中，PD患者出现二次步幅较短的可能性是非PD患者的1.5倍（95% CI = 1.23 - 1.78）。PD患者试图通过伸手抓住外部物体来恢复平衡的可能性也是非PD患者的1.6倍（95% CI = 1.13 - 2.15），而抓住物体的可能性则是非PD患者的5.0倍（95% CI = 1.23 - 20.0）。
除了PD患者因体重转移不正确而更易跌倒外，还发现两组在反应性步幅反应方面存在差异。这一关于PD患者跌倒特征的首个详细证据应有助于为临床医生和康复专业人员针对PD患者的跌倒及损伤预防方法提供参考。
