Objective: To identify factors that contribute to balance confidence and concern about falling in people with Parkinson’s disease (PD).

Background: Reduced balance confidence and greater concern about falling are constructs related to fear of falling and have been shown to be associated with recurrent falls in people with PD. It is important to identify factors associated with these constructs since they are potentially modifiable with exercise interventions.

Methods: Participants (n = 229) with mild to moderate PD (92% in Hoehn and Yahr stages 2-3) were enrolled in this study. The Activities-specific Balance Confidence Scale (ABC) was used to assess balance confidence and the Falls Efficacy Scale-International (FES-I) to assess concern about falling. Demographic and clinical data were recorded and participants were assessed with the Unified Parkinson’s Disease Rating Scale (UPDRS), activities of daily living (ADL) and motor sections, modified Hoehn and Yahr Scale, Schwab and England Scale, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Functional Reach Test and Timed Up and Go Test (TUG). Variables with p < 0.05 in univariate linear regression analyses were chosen to be entered into the stepwise multiple linear regression models.

Results: The strongest contributing factor to balance confidence was self-reported disability (as measured by the UPDRS ADL), explaining 43% of the variance in ABC scores. Other significant independent factors were balance while walking (as measured by the DGI) and gender, increasing the explained variance to 51% and 54%, respectively. In relation to concern about falling, the strongest contributing factor was balance while walking (as measured by the DGI), explaining 40% of the variance in FES-I scores. Other significant independent factors were self-reported disability (as measured by the UPDRS ADL) and functional balance (as measured by the BBS), increasing the explained variance to 42% and 43%, respectively.

Conclusions: Since disability for performing daily activities and balance performance, specially while walking with different gait task demands, are potentially modifiable, our results suggest that exercise interventions aiming to reduce fear of falling may consider these risk factors as targets. Future studies should evaluate whether non-motor symptoms, such as anxiety and depression, contribute to fear of falling.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/determinants-of-balance-confidence-and-concern-about-falling-in-people-with-parkinsons-disease/