Factors predicting fear of falling avoidance behavior in parkinsonisms

Article type: Research Article

Authors: Longhurst, Jason K.^{a; b; c; *} | Rider, John V.^{c; d} | Eckard, Kameron^c | Hammar, Ryan^c | Vukojevic, Franjo^c | Campbell, Jillian^e | Landers, Merrill R.^c

Affiliations: [a] Department of Physical Therapy and Athletic Training, Saint Louis University, St. Louis, MO, USA | [b] Department of Neurorehabilitation, Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, USA | [c] Department of Physical Therapy, University of Nevada - Las Vegas, Las Vegas, NV, USA | [d] School of Occupational Therapy, Touro University Nevada, Henderson, NV, USA | [e] Baylor Scott and White Institute for Rehabilitation, Dallas, TX, USA

Correspondence: [*] Address for correspondence: Jason K. Longhurst, PT, DPT, PhD, Department of Physical Therapy and Athletic Training, Saint Louis University, 3437 Caroline Street, Suite 1011, St. Louis, MO 63104, USA. E-mail: jason.longhurst@health.slu.edu.

Abstract: 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.

Keywords: Parkinsonism, fear of falling, avoidance behavior, gait velocity, freezing of gait

DOI: 10.3233/NRE-210267

Journal: NeuroRehabilitation, vol. 50, no. 1, pp. 65-73, 2022