AUTHOR=Haertner Linda , Elshehabi Morad , Zaunbrecher Laura , Pham Minh H. , Maetzler Corina , van Uem Janet M. T. , Hobert Markus A. , Hucker Svenja , Nussbaum Susanne , Berg Daniela , Liepelt-Scarfone Inga , Maetzler Walter
TITLE=Effect of Fear of Falling on Turning Performance in Parkinson’s Disease in the Lab and at Home
JOURNAL=Frontiers in Aging Neuroscience
VOLUME=10
YEAR=2018
URL=https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2018.00078
DOI=10.3389/fnagi.2018.00078
ISSN=1663-4365
ABSTRACT=Background: Parkinson’s disease (PD) is a neurodegenerative movement disorder associated with gait and balance problems and a substantially increased risk of falling. Falls occur often during complex movements, such as turns. Both fear of falling (FOF) and previous falls are relevant risk factors for future falls. Based on recent studies indicating that lab-based and home assessment of similar movements show different results, we hypothesized that FOF and a positive fall history would influence the quantitative turning parameters differently in the laboratory and home.
Methods: Fifty-five PD patients (43 underwent a standardized lab assessment; 40 were assessed over a mean of 12 days at home with approximately 10,000 turns per participant; and 28 contributed to both assessments) were classified regarding FOF and previous falls as “vigorous” (no FOF, negative fall history), “anxious” (FOF, negative fall history), “stoic” (no FOF, positive fall history) and “aware” (FOF, positive fall history). During the assessments, each participant wore a sensor on the lower back.
Results: In the lab assessment, FOF was associated with a longer turning duration and lowered maximum and middle angular velocities of turns. In the home evaluations, a lack of FOF was associated with lowered maximum and average angular velocities of turns. Positive falls history was not significantly associated with turning parameters, neither in the lab nor in the home.
Conclusion: FOF but not a positive fall history influences turning metrics in PD patients in both supervised and unsupervised environments, and this association is different between lab and home assessments. Our findings underline the relevance of comprehensive assessments including home-based data collection strategies for fall risk evaluation.