Department of Neurology, Jena University Hospital, 07743 Jena, Germany.
Department of Geriatrics, Halle University Hospital, 06120 Halle, Germany.
Sensors (Basel). 2023 Jan 18;23(3):1111. doi: 10.3390/s23031111.
Fear of falling (FOF) is common in Parkinson's disease (PD) and associated with distinct gait changes. Here, we aimed to answer, how quantitative gait assessment can improve our understanding of FOF-related gait in hospitalized geriatric patients with PD.
In this cross-sectional study of 79 patients with advanced PD, FOF was assessed with the Falls Efficacy Scale International (FES-I), and spatiotemporal gait parameters were recorded with a mobile gait analysis system with inertial measurement units at each foot while normal walking. In addition, demographic parameters, disease-specific motor (MDS-revised version of the Unified Parkinson's Disease Rating Scale, Hoehn & Yahr), and non-motor (Non-motor Symptoms Questionnaire, Montreal Cognitive Assessment) scores were assessed.
According to the FES-I, 22.5% reported low, 28.7% moderate, and 47.5% high concerns about falling. Most concerns were reported when walking on a slippery surface, on an uneven surface, or up or down a slope. In the final regression model, previous falls, more depressive symptoms, use of walking aids, presence of freezing of gait, and lower walking speed explained 42% of the FES-I variance.
Our study suggests that FOF is closely related to gait changes in hospitalized PD patients. Therefore, FOF needs special attention in the rehabilitation of these patients, and targeting distinct gait parameters under varying walking conditions might be a promising part of a multimodal treatment program in PD patients with FOF. The effect of these targeted interventions should be investigated in future trials.
跌倒恐惧（FOF）在帕金森病（PD）中很常见，并且与明显的步态变化有关。在这里，我们旨在回答，定量步态评估如何提高我们对住院老年 PD 患者与 FOF 相关步态的理解。
在这项对 79 名进展期 PD 患者的横断面研究中，使用跌倒效能量表国际版（FES-I）评估 FOF，同时使用带有惯性测量单元的移动步态分析系统在每个脚正常行走时记录时空步态参数。此外，评估人口统计学参数、疾病特异性运动（帕金森病修订版统一评定量表，Hoehn & Yahr）和非运动（非运动症状问卷，蒙特利尔认知评估）评分。
根据 FES-I，22.5%的患者报告了低水平的跌倒恐惧，28.7%的患者报告了中等水平的跌倒恐惧，47.5%的患者报告了高水平的跌倒恐惧。大多数担忧是在走在光滑的表面、不平坦的表面或上下斜坡时报告的。在最终的回归模型中，既往跌倒、更多的抑郁症状、使用助行器、存在冻结步态和较低的步行速度解释了 FES-I 方差的 42%。
我们的研究表明，FOF 与住院 PD 患者的步态变化密切相关。因此，在这些患者的康复中需要特别关注 FOF，针对不同行走条件下的特定步态参数可能是 PD 患者 FOF 多模式治疗计划的有前途的一部分。应在未来的试验中研究这些针对性干预的效果。
