Gazibara Tatjana, Kisic Tepavcevic Darija, Svetel Marina, Tomic Aleksandra, Stankovic Iva, Kostic Vladimir S, Pekmezovic Tatjana
Institute of Epidemiology, Visegradska 26a, Faculty of Medicine, University of Belgrade, Serbia.
Clinic of Neurology, Dr. Subotica 6, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Serbia.
Clin Neurol Neurosurg. 2017 Oct;161:51-55. doi: 10.1016/j.clineuro.2017.08.008. Epub 2017 Aug 24.
To describe circumstances of near-falls among persons with Parkinson's disease (PD), assess factors associated with near-falling and assess whether near-falls in the first 6 months are associated with falling in the latter 6 months over one year of follow-up.
In the period August 2011-December 2012, 120 consecutive persons with PD, who denied having fallen in the past 6 months, were recruited at Clinical center of Serbia in Belgrade. Occurrence of falling and near-falls was followed for one year.
A total of 31 persons with PD (25.8%) experienced near-falls, but did not fall. Of 42 fallers, 32 (76.2%) experienced near-falls. Tripping was the most common cause of near-falls among fallers, whereas postural instability was the most common in non-fallers. Regardless of falling experience, the most common manner to avoid fall was holding onto furniture or wall. After adjustment for multiple motor and non-motor PD features, more severe freezing of gait was associated with occurrence of near-falls over one year of follow-up (odds ratio [OR]=1.08, 95% confidence interval [CI] 1.01-1.16; p=0.043). Adjusted regression analysis did not show associations between near-falling in the first 6 months and falling in the latter 6 months of follow-up.
Near-falls commonly occur in persons with PD. More severe freezing of gait appears to predispose near-falling. Fall prevention programs focusing on balance maintenance when experiencing freezing of gait could potentially be useful in reduction of near-falls.
描述帕金森病（PD）患者险些跌倒的情况，评估与险些跌倒相关的因素，并评估在一年的随访中，前6个月的险些跌倒是否与后6个月的跌倒有关。
在2011年8月至2012年12月期间，在贝尔格莱德的塞尔维亚临床中心招募了120例连续的PD患者，这些患者否认在过去6个月内有过跌倒。对跌倒和险些跌倒的发生情况进行了一年的跟踪。
共有31例PD患者（25.8%）经历了险些跌倒，但未发生跌倒。在42例跌倒患者中，32例（76.2%）经历了险些跌倒。绊倒在跌倒患者中是险些跌倒最常见的原因，而姿势不稳在未跌倒患者中最常见。无论跌倒经历如何，避免跌倒最常见的方式是抓住家具或墙壁。在对多种运动和非运动PD特征进行调整后，在一年的随访中，更严重的步态冻结与险些跌倒的发生相关（比值比[OR]=1.08，95%置信区间[CI]1.01-1.16；p=0.043）。调整后的回归分析未显示随访前6个月的险些跌倒与后6个月的跌倒之间存在关联。
险些跌倒在PD患者中很常见。更严重的步态冻结似乎易导致险些跌倒。关注步态冻结时平衡维持的预防跌倒计划可能对减少险些跌倒有用。
