Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease

Abstract Falls are a common and disabling symptom in patients with Parkinson’s disease (PD). For prevention, it is important to understand the pathophysiology of falls in PD patients, but the predictors for the possible mechanisms underlying such falls have not been clearly elucidated. In this prosp...

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Autores principales:	Jinyoung Youn, Yasuyuki Okuma, Minho Hwang, Dongyeop Kim, Jin Whan Cho
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a2cce435e1854e1eb2f74f614b20927a
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spelling	oai:doaj.org-article:a2cce435e1854e1eb2f74f614b20927a2021-12-02T11:53:01ZFalling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease10.1038/s41598-017-04302-72045-2322https://doaj.org/article/a2cce435e1854e1eb2f74f614b20927a2017-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-04302-7https://doaj.org/toc/2045-2322Abstract Falls are a common and disabling symptom in patients with Parkinson’s disease (PD). For prevention, it is important to understand the pathophysiology of falls in PD patients, but the predictors for the possible mechanisms underlying such falls have not been clearly elucidated. In this prospective observational study, we investigated the implications of falling direction to predict the mechanisms of recurrent falls in PD patients. We enrolled 62 recurrent fallers with PD and divided them into two groups according to the main falling directions: 45 PD fallers who fell forward (forward fallers), and 17 PD fallers who fell in the other directions (non-forward fallers). Although there was no difference in demographic data, parkinsonism, or frontal lobe function, forward fallers showed more severe falls and tended to fall during walking or turning, while non-forward fallers usually fell during sitting/standing or turning. Additionally, forward fallers revealed higher score on a freezing of gait (FOG) questionnaire. Logistic regression analysis demonstrated that FOG was associated with falling forward, while balance impairment, akinetic-rigid subtype, and neuropsychiatric symptoms were associated with falling into the other directions. Our results indicate that FOG and balance impairment are two major mechanisms for recurrent falling in PD patients, and falling direction is an important predictor for these mechanisms.Jinyoung YounYasuyuki OkumaMinho HwangDongyeop KimJin Whan ChoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-6 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jinyoung Youn Yasuyuki Okuma Minho Hwang Dongyeop Kim Jin Whan Cho Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease
description	Abstract Falls are a common and disabling symptom in patients with Parkinson’s disease (PD). For prevention, it is important to understand the pathophysiology of falls in PD patients, but the predictors for the possible mechanisms underlying such falls have not been clearly elucidated. In this prospective observational study, we investigated the implications of falling direction to predict the mechanisms of recurrent falls in PD patients. We enrolled 62 recurrent fallers with PD and divided them into two groups according to the main falling directions: 45 PD fallers who fell forward (forward fallers), and 17 PD fallers who fell in the other directions (non-forward fallers). Although there was no difference in demographic data, parkinsonism, or frontal lobe function, forward fallers showed more severe falls and tended to fall during walking or turning, while non-forward fallers usually fell during sitting/standing or turning. Additionally, forward fallers revealed higher score on a freezing of gait (FOG) questionnaire. Logistic regression analysis demonstrated that FOG was associated with falling forward, while balance impairment, akinetic-rigid subtype, and neuropsychiatric symptoms were associated with falling into the other directions. Our results indicate that FOG and balance impairment are two major mechanisms for recurrent falling in PD patients, and falling direction is an important predictor for these mechanisms.
format	article
author	Jinyoung Youn Yasuyuki Okuma Minho Hwang Dongyeop Kim Jin Whan Cho
author_facet	Jinyoung Youn Yasuyuki Okuma Minho Hwang Dongyeop Kim Jin Whan Cho
author_sort	Jinyoung Youn
title	Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease
title_short	Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease
title_full	Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease
title_fullStr	Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease
title_full_unstemmed	Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease
title_sort	falling direction can predict the mechanism of recurrent falls in advanced parkinson’s disease
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/a2cce435e1854e1eb2f74f614b20927a
work_keys_str_mv	AT jinyoungyoun fallingdirectioncanpredictthemechanismofrecurrentfallsinadvancedparkinsonsdisease AT yasuyukiokuma fallingdirectioncanpredictthemechanismofrecurrentfallsinadvancedparkinsonsdisease AT minhohwang fallingdirectioncanpredictthemechanismofrecurrentfallsinadvancedparkinsonsdisease AT dongyeopkim fallingdirectioncanpredictthemechanismofrecurrentfallsinadvancedparkinsonsdisease AT jinwhancho fallingdirectioncanpredictthemechanismofrecurrentfallsinadvancedparkinsonsdisease
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Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease

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