Longhurst Jason K, Hooyman Andrew, Landers Merrill R, Mancini Martina, Franzén Erika, Leavy Breiffni, Johansson Hanna, Peterson Daniel
Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO, USA.
School of Biological Health Systems Engineering, Arizona State University, Tempe, AZ, USA.
Neurorehabil Neural Repair. 2025 Feb;39(2):114-125. doi: 10.1177/15459683241300456. Epub 2024 Nov 27.
The congruence or discordance between actual and perceived balance ability has been proposed to be linked to functional outcomes such as falls. However, gaps remain in our ability to quantify discordance, and its relationship to relevant outcomes.
To investigate a novel quantification of concordance/discordance between balance performance and perception and determine the relationship to falls among people with Parkinson's disease (PwPD).
Data from 244 PwPD were aggregated from 5 previously conducted studies. Variables extracted included age, sex, Activities-Specific Balance Confidence scale (ABC; perceived balance), Timed Up and Go (TUG; balance performance), Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS) part III scores, and retrospective falls (6- or 12-month). Data validation between studies was established. Discordance was quantified as the difference between an individual's predicted ABC, based upon their TUG score, to their reported ABC.
Two methods for calculating discordance were tested: simple linear regression and segmented regression. As there were no differences between the bootstrap distributions of both approaches ( = .520), simple linear regression was utilized for the subsequent logistic regression model. Discordance was the only statistically significant predictor of fall status (OR = 0.98, = .003), after controlling for age, MDS-UPDRS part III, sex, and TUG. The inclusion of discordance in the logistic regression model boosted the predictive accuracy by 58%.
Discordance between actual and perceived balance was uniquely related to retrospective fall history among PwPD. Clinicians and researchers should consider discordance between actual and perceived balance as a potentially modifiable target to minimize falls.
实际平衡能力与感知平衡能力之间的一致性或不一致性被认为与跌倒等功能结局相关。然而，我们在量化不一致性及其与相关结局的关系方面仍存在差距。
研究帕金森病患者平衡表现与感知之间一致性/不一致性的一种新的量化方法，并确定其与跌倒的关系。
汇总了先前进行的5项研究中的244例帕金森病患者的数据。提取的变量包括年龄、性别、特定活动平衡信心量表（ABC；感知平衡）、计时起立行走测试（TUG；平衡表现）、运动障碍协会统一帕金森病评定量表（MDS-UPDRS）第三部分得分以及回顾性跌倒情况（6个月或12个月）。建立了研究之间的数据验证。不一致性被量化为根据个体的TUG得分预测的ABC与他们报告的ABC之间的差异。
测试了两种计算不一致性的方法：简单线性回归和分段回归。由于两种方法的自助分布之间没有差异（P = 0.520），因此在后续的逻辑回归模型中使用简单线性回归。在控制了年龄、MDS-UPDRS第三部分、性别和TUG之后，不一致性是跌倒状态的唯一具有统计学意义的预测因素（OR = 0.98，P = 0.003）。在逻辑回归模型中纳入不一致性将预测准确性提高了58%。
实际平衡与感知平衡之间的不一致性与帕金森病患者的回顾性跌倒史独特相关。临床医生和研究人员应将实际平衡与感知平衡之间的不一致性视为一个潜在的可改变目标，以尽量减少跌倒。
