Department of Neuroscience, Faculty of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran.
Mechanical Engineering Department, and Cross Appointed with Djawad Movafaghian Research Center in Neuro-rehabilitation Technologies, Sharif University of Technology, Tehran, Iran.
Biomed Eng Online. 2020 Aug 18;19(1):64. doi: 10.1186/s12938-020-00808-w.
Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson's disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error.
In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients.
Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRs; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF-related behavior(s).
FTR (the ratio between FTR and FTR) was strongly correlated with the FES-I (r = - 0.63, p < 0.001), Pull test (r = - 0.65, p < 0.001), Timed Up and Go test (r = - 0.57, p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model of FTR was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83.
Using the proposed assessment technique, we can accurately predict the intensity of FoF in PD patients. Also, the FTR index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.
跌倒恐惧（Fear of falling，FoF）是指对跌倒的持续担忧，导致患者限制甚至停止其力所能及的日常活动。70%的帕金森病（Parkinson's disease，PD）患者因 FoF 而活动受限。及时识别 FoF 对于防止其对生活质量产生额外的不良影响至关重要。自评问卷常用于评估 FoF，但可能容易出现人为错误。
本研究旨在寻找一种新的姿势稳定性指标，以客观预测 PD 患者 FoF 的强度及其相关行为。
38 名 PD 患者参与了本研究（平均年龄 61.2 岁），根据跌倒效能量表-国际版（Falls Efficacy Scale-International，FES-I），10 名患者（26.32%）被确定为 FoF 程度较低，其余 28 名患者（73.68%）为 FoF 程度较高。我们使用针对每个个体校准的稳定性极限任务，并研究了预测 FoF 强度的姿势策略。基于不同矩形区域（i=1、2 和 3）的压力中心存在模式，提取了新的参数（功能时间比 FTRs；functional time ratio）。任务在两个高度进行，以研究与 FoF 相关的行为。
FTR（FTR 与 FTR 的比值）与 FES-I（r=-0.63，p<0.001）、Pull 测试（r=-0.65，p<0.001）、计时起立行走测试（Timed Up and Go test，r=-0.57，p<0.001）和 Berg 平衡量表（r=0.62，p<0.001）均呈强相关。FTR 模型被确定为预测 PD 参与者 FoF 强度的最佳拟合模型（敏感性=96.43%，特异性=80%），使用阈值水平≤2.83。
使用所提出的评估技术，我们可以准确预测 PD 患者 FoF 的强度。此外，FTR 指数可以作为一种机械生物标志物，用于感知 PD 患者与 FoF 相关的姿势不稳定。
