Assessment of Risk Factors for Falls among Patients with Parkinson’s Disease

Abstract

Introduction. The aim of this study was to assess the risk factors for falls in patients with Parkinson’s disease. Materials and Methods. The study comprised 53 participants (52.8% women and 47.2% men). The Hoehn and Yahr 5-point disability scale was used to assess the severity of Parkinson’s disease. The Tinetti Balance and Gait Scale were used to evaluate the risk of falls. The Katz scale was used to test the independence of people with PD. The Falls Efficacy Scale-International Short Form (FES-I) was implemented to assess fear of falling. Results. The majority of participants was at a high risk of falls, being at the same level for women and men. A significant relationship was noted between the risk of falls and subjective assessment of mobility ( ${\chi }^2=31.86$ , $p<0.001$ ), number of falls ( ${\chi }^2=37.92$ , $p<0.001$ ), independence of the subjects ( ${\chi }^2=19.28$ , $p<0.001$ ), type of injury suffered during the fall ( ${\chi }^2=36.93$ , $p<0.001$ ), external factors ( ${\chi }^2=33.36$ , $p<0.001$ ), and the level of fear of falling ( ${\chi }^2=8.88$ , $p<0.001$ ). A significant relationship also occurred between the number of falls and the fear of falling ( ${\chi }^2=33.49$ , $p<0.001$ ) and between the number of falls and disease severity ( ${\chi }^2=45.34$ , $p<0.001$ ). The applied physiotherapy did not reduce the risk of falls ( ${\chi }^2=3.18$ , $p=0.17$ ). Conclusions. Individuals who rated their mobility as good or excellent were at a low risk of falls. People who fell more times were at a high risk of falling. People more independent were at a low risk of falls. Previous injuries were the most associated with being at risk of falling. Uneven surfaces and obstacles on one’s path are the external factors most associated with the risk of falling. People with low levels of fall anxiety were at a low risk of falls. Most people with low fall anxiety have never fallen. Additionally, the majority of patients with stage 1 of the disease have not fallen at all. The reason for the ineffectiveness of physiotherapy may be due to the exercise programs used and the lack of systematic implementation of them. PD is different for each patient; thus, it is important to select individually customized physiotherapy depending on motor and nonmotor symptoms, as well as general health of a patient.