Mehdizadeh Maryam, Lajevardi Laleh, Habibi Seyed Amir Hassan, ArabBaniasad Mina, Baghoori Delaram, Daneshjoo Fatemeh, Taghizadeh Ghorban
PhD Student Neuroscience, Department of Advance Technology of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Assistant Professor, Department of Occupational Therapy, School of Rehabilitation, Iran University of Medical Sciences, Iran University of Medical Sciences, Tehran, Iran.
Med J Islam Repub Iran. 2016 Dec 19;30:453. eCollection 2016.
Despite the negative effect of fear of falling during functioning and social participation of patients with Parkinson' disease, so far, only few studies have investigated its effect on the quality of life in these patients. We aimed to investigate the association between fear of falling and quality of life controlling for balance impairments based on hip and ankle strategy in drug On- and Off-phase of patients with idiopathic Parkinson' disease. In this non-experimental cross-sectional study, 139 patients with idiopathic Parkinson' disease (100 male, 39 female) by mean± SD age of 60.2±12.27 years, mean±SD time since diagnosis of 6.7±5.53 years and mean±SD Hoehn and Yahr stage of 2.8±1.49 were selected by a simple non-probability method. Balance function was measured by a functional reach test with hip and ankle strategy. The Persian version of the selfcompleted Fall Efficacy Scale-International and Parkinson's disease quality of life questionnaire was used to evaluate fear of falling and quality of life, respectively. The results showed that the score of all dimensions of quality of life (i.e., mobility, activities of daily living, emotional wellbeing, stigma, social support, cognition, communication and bodily discomfort) were significantly affected by the intensity of fear of falling. Multiple regression analysis indicated a significant association between fear of falling and quality of life in a way that fear of falling explained 11% to 47% and 12% to 43% of variance in drug On-phase, as well as 8% to 45% and 9% to 48% of variance in the drug Off-phase in dimensions of quality of life after controlling for balance function based on hip and ankle strategy, respectively. In the drug On-phase, the strongest association (R=0.85, p<0.001) was found between fear of falling and mobility dimension of quality of life. In the drug Off-phase, the strongest relation was observed between fear of falling and mobility (R=0.82, p<0.001) as well as activities of daily living (R=0.78-0.79, p<0.001) dimensions. This study found that fear of falling affects the quality of life of patients with Parkinson' disease beyond its relationship with balance impairments based on the hip and ankle strategy in both drug On- and Off-phase.
尽管帕金森病患者在功能和社交参与过程中对跌倒的恐惧具有负面影响，但到目前为止，仅有少数研究调查了其对这些患者生活质量的影响。我们旨在研究特发性帕金森病患者在药物开启和关闭阶段，基于髋部和踝部策略控制平衡障碍的情况下，跌倒恐惧与生活质量之间的关联。在这项非实验性横断面研究中，通过简单的非概率方法选取了139例特发性帕金森病患者（男性100例，女性39例），平均年龄±标准差为60.2±12.27岁，平均诊断后时间±标准差为6.7±5.53年，平均Hoehn和Yahr分期为2.8±1.49。通过采用髋部和踝部策略的功能性伸展测试来测量平衡功能。分别使用波斯语版的自我完成的国际跌倒效能量表和帕金森病生活质量问卷来评估跌倒恐惧和生活质量。结果表明，跌倒恐惧的强度显著影响生活质量的所有维度（即移动性、日常生活活动、情绪健康、耻辱感、社会支持、认知、沟通和身体不适）。多元回归分析表明跌倒恐惧与生活质量之间存在显著关联，在基于髋部和踝部策略控制平衡功能后，跌倒恐惧在药物开启阶段解释了生活质量维度中11%至47%以及12%至43%的方差，在药物关闭阶段分别解释了8%至45%以及9%至48%的方差。在药物开启阶段，跌倒恐惧与生活质量的移动性维度之间发现最强的关联（R = 0.85，p < 0.001）。在药物关闭阶段，跌倒恐惧与移动性（R = 0.82，p < 0.001）以及日常生活活动（R = 0.78 - 0.79，p < 0.001）维度之间观察到最强的关系。本研究发现，在药物开启和关闭阶段，跌倒恐惧对帕金森病患者生活质量的影响超出了其与基于髋部和踝部策略的平衡障碍之间的关系。
