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

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 ob...

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Autores principales: Youn, Jinyoung, Okuma, Yasuyuki, Hwang, Minho, Kim, Dongyeop, Cho, Jin Whan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478627/
https://www.ncbi.nlm.nih.gov/pubmed/28634343
http://dx.doi.org/10.1038/s41598-017-04302-7
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author Youn, Jinyoung
Okuma, Yasuyuki
Hwang, Minho
Kim, Dongyeop
Cho, Jin Whan
author_facet Youn, Jinyoung
Okuma, Yasuyuki
Hwang, Minho
Kim, Dongyeop
Cho, Jin Whan
author_sort Youn, Jinyoung
collection PubMed
description 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.
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spelling pubmed-54786272017-06-23 Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease Youn, Jinyoung Okuma, Yasuyuki Hwang, Minho Kim, Dongyeop Cho, Jin Whan Sci Rep Article 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. Nature Publishing Group UK 2017-06-20 /pmc/articles/PMC5478627/ /pubmed/28634343 http://dx.doi.org/10.1038/s41598-017-04302-7 Text en © The Author(s) 2017 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Youn, Jinyoung
Okuma, Yasuyuki
Hwang, Minho
Kim, Dongyeop
Cho, Jin Whan
Falling Direction can Predict the Mechanism of Recurrent Falls in Advanced Parkinson’s Disease
title 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_short 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
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5478627/
https://www.ncbi.nlm.nih.gov/pubmed/28634343
http://dx.doi.org/10.1038/s41598-017-04302-7
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