Factors predicting fear of falling avoidance behavior in parkinsonisms

• Published in: NeuroRehabilitation (Reading, Mass.) Vol. 50; no. 1; pp. 65 - 73
• Main Authors: Longhurst, Jason K., Rider, John V., Eckard, Kameron, Hammar, Ryan, Vukojevic, Franjo, Campbell, Jillian, Landers, Merrill R.
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.01.2022; IOS Press BV
• Subjects: Accidental Falls - prevention & control; Avoidance behavior; Avoidance Learning; Balance; Brain diseases; Cross-Sectional Studies; Demography; Falls; Fear; Fear & phobias; Gait; Gait Disorders, Neurologic - etiology; Health behavior; Humans; Medical records; Mobility; Movement disorders; Neurodegenerative diseases; Parkinson Disease; Parkinson's disease; Retrospective Studies; Tonic immobility; Parkinsonism; fear of falling; avoidance behavior; freezing of gait; gait velocity
• ISSN: 1053-8135; 1878-6448
• DOI: 10.3233/NRE-210267

BACKGROUND: Fear of falling avoidance behavior (FFAB) is common in parkinsonisms and results in potentially mitigable downstream consequences. OBJECTIVE: Determine the characteristics of individuals with parkinsonisms most associated with FFAB. METHODS: A retrospective, cross-sectional study was conducted from medical records data of 142 patients with parkinsonisms. These data included: demographics (age, sex), disease severity (Movement Disorders Society –Unified Parkinson’s Disease Rating Scale Part III (MDS-UPDRS III), years since diagnosis), fall history (number of fall injuries in previous year), and gait and balance function (five times sit to stand, MiniBESTest, Timed Up and Go (TUG), dual-task TUG, ten-meter walk test (10MWT), observed freezing of gait (FOG) (MDS-UPDRS III item 11)). RESULTS: 10MWT (p < .001) and MDS-UPDRS III item 11 (p < .014) were significantly associated with FFAB above and beyond disease severity, which also contributed significantly to the overall model (ps < .046). Fall history was not associated with FFAB. CONCLUSION: Our findings suggest that the largest portion of variability in FFAB is explained by gait velocity and FOG; however, disease severity also explains a significant portion of the variability of FFAB. Further investigation into factors predictive of FFAB and mitigation of downstream consequences, using more robust designs, is warranted.