Article

OBJECTIVE: To examine fall risk trajectories occurring naturally in a sample of
individuals with early to middle stage Parkinson disease (PD). DESIGN: Latent
class analysis, specifically growth mixture modeling (GMM), of longitudinal fall
risk trajectories. SETTING: Assessments were conducted at 1 of 4 universities.
PARTICIPANTS: Community-dwelling participants with PD of a longitudinal cohort
study who attended at least 2 of 5 assessments over a 2-year follow-up period
(N=230). INTERVENTIONS:
Not applicable. MAIN OUTCOME MEASURES: Fall risk
trajectory (low, medium, or high risk) and stability of fall risk trajectory
(stable or fluctuating). Fall risk was determined at 6 monthly intervals using a
simple clinical tool based on fall history, freezing of gait, and gait speed.
RESULTS: The GMM optimally grouped participants into 3 fall risk trajectories
that closely mirrored baseline fall risk status (P=.001). The high fall risk
trajectory was most common (42.6%) and included participants with longer and more
severe disease and with higher postural instability and gait disability (PIGD)
scores than the low and medium fall risk trajectories (P<.001). Fluctuating fall
risk (posterior probability <0.8 of belonging to any trajectory) was found in
only 22.6% of the sample, most commonly among individuals who were transitioning
to PIGD predominance. CONCLUSIONS: Regardless of their baseline characteristics,
most participants had clear and stable fall risk trajectories over 2 years.
Further investigation is required to determine whether interventions to improve
gait and balance may improve fall risk trajectories in people with PD.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS