Diagnosis of Fall Risk in Parkinson Disease: An Analysis of Individual and Collective Clinical Balance Test Interpretation
Open Access
- 1 March 2008
- journal article
- Published by Oxford University Press (OUP) in PTJ: Physical Therapy & Rehabilitation Journal
- Vol. 88 (3), 323-332
- https://doi.org/10.2522/ptj.20070082
Abstract
Background and Purpose: Parkinson disease (PD) results in an increased frequency of falls relative to the frequency in neurologically healthy people. The purpose of this study was to compare the accuracy of PD fall risk diagnosis based on one test with that based on the collective interpretation of multiple tests. Participants: Seventy people with PD (mean age=73.91 years) participated in this study. Method: Clinical balance tests were conducted during the initial examinations of people with PD. Validity indices were calculated for individual tests and compared with validity indices calculated for a combination of multiple tests. Results: Thirty-six participants reported a fall history. Analysis of individual tests revealed broad variations in validity indices, whereas the collective interpretation of multiple tests improved sensitivity and negative likelihood ratios. Discussion and Conclusion: Collective interpretation of clinical balance tests resulted in fewer false-negative results and more substantial adjustments to the posttest probability of being a “faller” than the interpretation of one test alone. These results should be confirmed in a prospective examination of fall risk in PD.Keywords
This publication has 36 references indexed in Scilit:
- Cueing training in the home improves gait-related mobility in Parkinson's disease: the RESCUE trialJournal of Neurology, Neurosurgery & Psychiatry, 2007
- A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson's diseaseJournal of Neurology, Neurosurgery & Psychiatry, 2006
- Motor Learning and Parkinson Disease: Refinement of Movement Velocity and Endpoint Excursion in a Limits of Stability Balance TaskNeurorehabilitation and Neural Repair, 2006
- Predictors of falls and fractures in bradykinetic rigid syndromes: a retrospective studyJournal of Neurology, Neurosurgery & Psychiatry, 2006
- Multiple balance tests improve the assessment of postural stability in subjects with Parkinson's diseaseJournal of Neurology, Neurosurgery & Psychiatry, 2005
- Are Measures Employed in the Assessment of Balance Useful for Detecting Differences among Groups that Vary by Age and Disease State?Journal of Geriatric Physical Therapy, 2005
- Falls and injuries resulting from falls among patients with Parkinson's disease and other parkinsonian syndromesMovement Disorders, 2004
- The effect of physical therapy on balance of patients with Parkinsonʼs diseaseInternational Journal of Rehabilitation Research, 2004
- A Primer on the Precision and Accuracy of the Clinical ExaminationJAMA, 1992
- Fracture Risk in Patients with Parkinsonism: A Population-based Study in Olmsted County, MinnesotaAge and Ageing, 1992