Abstract
This study sought to determine whether the backward-stepping Push and Release (P&R) Test and the Pull Test, or comprehensive batteries of postural instability (the Mini-BESTest and Brief-BESTest), significantly improve the prediction of future falls beyond knowing a person’s baseline fall history. Complete data were available for 43 of 80 participants with PD. At baseline, participants completed the BESTest (which was scored for all versions and includes the P&R Test), the Unified PD Rating Scale (UPDRS) motor section (which includes the Pull Test), and the participants’ reported falls experienced in the previous 6 months. Participants were classified as recurrent fallers if they reported more than one fall in the 12 months subsequent to baseline. Stepwise logistic regressions determined whether the P&R Test, Pull Test, Brief-BESTest, Mini-BESTest, or UPDRS motor score improved predictions of recurrent fallers independent of baseline fall-group status. Independently, all assessments significantly predicted future recurrent fallers, but only the Mini-BESTest and Brief-BESTest significantly improved predictions of future recurrent fallers independent of baseline fall-group status. The results suggest that, although single tests of reactive postural control do not offer significant predictive benefit, predictions of future recurrent fallers with PD do benefit from a balance examination in addition to knowing whether an individual has a recent history of falls.
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Acknowledgments
This work was supported by the Davis Phinney Foundation, American Parkinson Disease Association (APDA), Greater St. Louis APDA and the APDA Center for Advanced Research at Washington University in St. Louis.
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The study was approved by the institutional review board and was performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Jacobs, J.V., Earhart, G.M. & McNeely, M.E. Can postural instability tests improve the prediction of future falls in people with Parkinson’s disease beyond knowing existing fall history?. J Neurol 263, 133–139 (2016). https://doi.org/10.1007/s00415-015-7950-x
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DOI: https://doi.org/10.1007/s00415-015-7950-x