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The relation between falls risk and movement variability in Parkinson’s disease

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Abstract

Falls are a major health concern for older adults with Parkinson’s disease (PD). This study was designed to examine differences in falls risk and its relation to changes in the average and variability (i.e. intra-individual variability) of reaction time (RT), finger tapping, standing balance and walking between healthy older adults and persons with PD. Thirty-nine adults with PD (70.0 ± 8.1 years) and 29 healthy older adults (66.8 ± 10.4 years) participated in this study. Falls risk (using the physiological profile assessment), gait, RT, balance and tapping responses were assessed for all persons. Results demonstrated that individuals with PD exhibited a greater risk of falling coupled with a general slowing of motor function covering declines in walking, RT and finger tapping. In addition, the movement responses of the PD group were more variable than the healthy older adults. Correlation results revealed group differences with regards to the neuromotor measures which were significantly correlated with falls risk. For the PD group, gait measures were highly correlated with their falls risk while, for the healthy older adults, falls risk was linked to balance measures even though PD persons had increased sway. Overall, persons with PD were at greater falls risk, moved slower and with increased variability compared to the healthy older adults. Further, while there are some similarities between the two groups in terms of those measures related to falls risk, there were also several differences which highlight that persons with PD can have different risk factors for falling compared to healthy adults of similar age.

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References

  • Archer SE, Winter DA, Prince F (1994) Initiation of gait: a comparison between young, elderly, and Parkinson’s disease subjects. Gait Posture 2:56

    Article  Google Scholar 

  • Artieda J et al (1992) Temporal discrimination is abnormal in Parkinson’s disease. Brain 115(Pt 1):199–210

    Article  PubMed  Google Scholar 

  • Arunachalam R, Weerasinghe VS, Mills KR (2005) Motor control of rapid sequential finger tapping in humans. J Neurophysiol 94:2162–2170

    Article  CAS  PubMed  Google Scholar 

  • Avanzino L et al (2013) Motor timing deficits in sequential movements in Parkinson disease are related to action planning: a motor imagery study. PLoS ONE 8:e75454

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Balash Y et al (2005) Falls in outpatients with Parkinson’s disease: frequency, impact and identifying factors. J Neurol 252:1310–1315

    Article  CAS  PubMed  Google Scholar 

  • Batterham PJ et al (2014) Intra-individual reaction time variability and all-cause mortality over 17 years: a community-based cohort study. Age Ageing 43:84–90

    Article  PubMed  Google Scholar 

  • Bauermeister S et al (2017) Intraindividual variability and falls in older adults. Neuropsych 31:20–27

    Article  Google Scholar 

  • Bloem B et al (2004) Falls and freezing of gait in Parkinson’s disease: a review of two interconnected, episodic phenomena. Mov Disord 19:871–884

    Article  PubMed  Google Scholar 

  • Bryant MS et al (2011) Gait variability in Parkinson’s disease: influence of walking speed and dopaminergic treatment. Neurol Res 33:959–964

    Article  PubMed  PubMed Central  Google Scholar 

  • Bryant MS et al (2016) Gait variability in Parkinson’s disease: levodopa and walking direction. Acta Neurol Scand 134:83–86

    Article  CAS  PubMed  Google Scholar 

  • Cooper JA et al (1994) Slowed central processing in simple and go/no-go reaction time tasks in Parkinson’s disease. Brain 117(Pt 3):517–529

    Article  PubMed  Google Scholar 

  • Dennison A, Noorigian J, Robinson K (2007) Falling in Parkinson disease: identifying and prioritizing risk factors in recurrent fallers. Am J Phys Med Rehabil 86:621–632

    Article  PubMed  Google Scholar 

  • Djuric-Jovicic M et al (2016) Finger tapping analysis in patients with Parkinson’s disease and atypical parkinsonism. J Clin Neurosci 30:49–55

    Article  PubMed  Google Scholar 

  • Dykiert D et al (2012) Age differences in intra-individual variability in simple and choice reaction time: systematic review and meta-analysis. PLoS ONE 7:e45759

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Fahn S, Elton R, UPDRS Development Committee (1987) Unified Parkinson’s disease rating scale. In: Fahn S, Marsden CD, Calne DB, Goldstein M (eds) Recent developments in Parkinson’s disease, vol 2. Macmillan Health Care Information. Florham Park, NJ, pp 153–163

    Google Scholar 

  • Fasano A et al (2017) Falls in Parkinson’s disease: a complex and evolving picture. Mov Disord 32:1524–1536

    Article  PubMed  Google Scholar 

  • Gauntlett-Gilbert J, Brown VJ (1998) Reaction time deficits and Parkinson’s disease. Neurosci Biobehav Rev 22:865–881

    Article  CAS  PubMed  Google Scholar 

  • Gunn H et al (2018) Relationship between physiological and perceived fall risk in people with multiple sclerosis: implications for assessment and management. Arch Phys Med Rehabil 99:2022–2029

    Article  PubMed  Google Scholar 

  • Hausdorff JM (2007) Gait dynamics, fractals and falls: finding meaning in the stride-to-stride fluctuations of human walking. Hum Mov Sci 26:555–589

    Article  PubMed  PubMed Central  Google Scholar 

  • Hess CW, Hallett M (2017) The phenomenology of Parkinson’s disease. Semin Neurol 37:109–117

    Article  PubMed  PubMed Central  Google Scholar 

  • Hoang PD et al (2016) Fall risk in people with MS: a physiological profile assessment study. Mult Scler J Exp Transl Clin 2:2055217316641130

    PubMed  PubMed Central  Google Scholar 

  • Hultsch DF, MacDonald SW, Dixon RA (2002) Variability in reaction time performance of younger and older adults. J Gerontol B Psychol Sci Soc Sci 57:P101-115

    Article  PubMed  Google Scholar 

  • Kerr GK et al (2010) Predictors of future falls in Parkinson disease. Neurology 75:116–124

    Article  CAS  PubMed  Google Scholar 

  • Kim SD et al (2018) Parkinson disease. Handb Clin Neurol 159:173–193

    Article  PubMed  Google Scholar 

  • Kutukcu Y et al (1999) Simple and choice reaction time in Parkinson’s disease. Brain Res 815:367–372

    Article  CAS  PubMed  Google Scholar 

  • Latt MD et al (2009) Clinical and physiological assessments for elucidating falls risk in Parkinson’s disease. Mov Disord 24:1280–1289

    Article  PubMed  Google Scholar 

  • Lipsitz LA (2002) Dynamics of stability: the physiologic basis of functional health and frailty. J Gerontol A Biol Sci Med Sci 57:B115-125

    Article  PubMed  Google Scholar 

  • Lipsitz LA, Goldberger AL (1992) Loss of `complexity’ and aging: potential applications of fractals and chaos theory to senescence. JAMA 267:1806–1809

    Article  CAS  PubMed  Google Scholar 

  • Lorbach ER et al (2007) Physiological falls risk assessment in older people with Alzheimer’s disease. Dement Geriatr Cogn Disord 24:260–265

    Article  PubMed  Google Scholar 

  • Lord SR, Menz HB, Tiedemann A (2003) A physiological profile approach to falls risk assessment and prevention. Phys Ther 83:237–252

    Article  PubMed  Google Scholar 

  • Lord S et al (2007) Falls in older people: risk factors and strategies for prevention. Cambridge University Press, Cambridge

    Book  Google Scholar 

  • Lord SR, Delbaere K, Gandevia SC (2016) Use of a physiological profile to document motor impairment in ageing and in clinical groups. J Physiol 594:4513–4523

    Article  CAS  PubMed  Google Scholar 

  • Martinez-Martin P (2004) Clinical gait and balance scales for Parkinson’s disease. J Neurol Sci 221:125

    Article  CAS  PubMed  Google Scholar 

  • Mitoma H et al (1995) Characteristic features of parkinsonian gait; a kinematic and EMG analysis. EEG Clin Neurophys 97:S212

    Google Scholar 

  • Moon Y et al (2016) Gait variability in people with neurological disorders: a systematic review and meta-analysis. Hum Mov Sci 47:197–208

    Article  PubMed  Google Scholar 

  • Morris ME et al (2001) The biomechanics and motor control of gait in Parkinson disease. Clin Biomech 16:459–470

    Article  CAS  Google Scholar 

  • Morrison S et al (2010) Balance training reduces falls risk in older individuals with type 2 diabetes. Diabetes Care 42:277–287

    Google Scholar 

  • Morrison S, Newell KM, Kavanagh JJ (2017) Differences in postural tremor dynamics with age and neurological disease. Exp Brain Res 235:1719–1729

    Article  PubMed  Google Scholar 

  • Morrison S et al (2018) Neuromotor and cognitive responses of adults with autism spectrum disorder compared to neurotypical adults. Exp Brain Res 236:2321–2332

    Article  PubMed  Google Scholar 

  • Nardone A, Schieppati M (2006) Balance in Parkinson’s disease under static and dynamic conditions. Mov Disord 21:1515–1520

    Article  PubMed  Google Scholar 

  • Perera T et al (2018) Balance control systems in Parkinson’s disease and the impact of pedunculopontine area stimulation. Brain 141:3009–3022

    Article  PubMed  PubMed Central  Google Scholar 

  • Postuma RB et al (2015) MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 30:1591–1601

    Article  Google Scholar 

  • Postuma RB et al (2018) Validation of the MDS clinical diagnostic criteria for Parkinson’s disease. Mov Disord 33:1601–1608

    Article  CAS  PubMed  Google Scholar 

  • Puyjarinet F et al (2019) Heightened orofacial, manual, and gait variability in Parkinson’s disease results from a general rhythmic impairment. NPJ Parkinsons Dis 5:19

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Samii A, Nutt JG, Ransom PBR (2004) Parkinson’s disease. The Lancet 363:1783–1793

    Article  CAS  Google Scholar 

  • Wang L, Hamaker E, Bergeman CS (2012) Investigating inter-individual differences in short-term intra-individual variability. Psychol methods 17:567–581

    Article  PubMed  Google Scholar 

  • Yahalom G et al (2004) Hand rhythmic tapping and timing in Parkinson’s disease. PD Related Disord 10:143–148

    Article  CAS  Google Scholar 

Download references

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Correspondence to Steven Morrison.

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Communicated by Bill J Yates.

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Morrison, S., Moxey, J., Reilly, N. et al. The relation between falls risk and movement variability in Parkinson’s disease. Exp Brain Res 239, 2077–2087 (2021). https://doi.org/10.1007/s00221-021-06113-9

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  • DOI: https://doi.org/10.1007/s00221-021-06113-9

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