Neurology, Neurophysiology and Neurobiology Unit, Department of Medicine, Università Campus Bio-Medico Di Roma, Viale Alvaro del Portillo, 21, 00128, Rome, Italy.
Montfort Brain Monitor, Binyamina, Israel.
Neurol Sci. 2021 Aug;42(8):3089-3092. doi: 10.1007/s10072-021-05351-7. Epub 2021 May 27.
Falls could be serious events in Parkinson's disease (PD). Patient remote monitoring strategies are on the raise and may be an additional aid in identifying patients who are at risk of falling. The aim of the study was to evaluate if balance and timed-up-and-go data obtained by a smartphone application during COVID-19 lockdown were able to predict falls in PD patients.
A cohort of PD patients were monitored for 4 weeks during the COVID-19 lockdown with an application measuring static balance and timed-up-and-go test. The main outcome was the occurrence of falls (UPDRS-II item 13) during the observation period.
Thirty-three patients completed the study, and 4 (12%) reported falls in the observation period. The rate of falls was reduced with respect to patient previous falls history (24%). The stand-up time and the mediolateral sway, acquired through the application, differed between "fallers" and "non-fallers" and related to the occurrence of new falls (OR 1.7 and 1.6 respectively, p < 0.05), together with previous falling (OR 7.5, p < 0.01). In a multivariate model, the stand-up time and the history of falling independently related to the outcome (p < 0.01).
Our study provides new data on falls in Parkinson's disease during the lockdown. The reduction of falling events and the relationship with the stand-up time might suggest that a different quality of falls occurs when patient is forced to stay home - hence, clinicians should point their attention also on monitoring patients' sit-to-stand body transition other than more acknowledged features based on step quality.
跌倒可能是帕金森病（PD）患者的严重事件。患者远程监测策略正在增加，这可能有助于识别有跌倒风险的患者。本研究旨在评估在 COVID-19 封锁期间通过智能手机应用程序获得的平衡和计时起立行走测试数据是否能够预测 PD 患者的跌倒。
在 COVID-19 封锁期间，通过应用程序测量静态平衡和计时起立行走测试，对一组 PD 患者进行了 4 周的监测。主要结果是观察期间发生跌倒（UPDRS-II 项目 13）。
33 名患者完成了研究，有 4 名（12%）在观察期间报告跌倒。与患者以前的跌倒史相比，跌倒率有所降低（24%）。通过应用程序获得的站立时间和横向摆动在“跌倒者”和“非跌倒者”之间存在差异，并且与新跌倒的发生相关（OR 分别为 1.7 和 1.6，p<0.05），以及以前的跌倒史（OR 为 7.5，p<0.01）。在多变量模型中，站立时间和跌倒史独立与结果相关（p<0.01）。
我们的研究提供了 COVID-19 封锁期间帕金森病跌倒的新数据。跌倒事件的减少以及与站立时间的关系可能表明，当患者被迫留在家中时，会发生不同质量的跌倒 - 因此，临床医生除了基于步质量的更公认特征外，还应注意监测患者从坐下到站起的身体过渡。
