Category: Parkinson's Disease: Pathophysiology
Objective: To elucidate in which motor state Parkinson’s disease (PD) patients with motor fluctuations fall.
Background: Recurrent falls are a disabling feature of PD and have a significant negative impact on the patients’ quality of life. There have been only a few studies that aimed to evaluate the motor state of patients when they fall in relation to wearing-off and disease severity.
Method: We recruited 36 PD patients who had the wearing-off and who had fallen at least once in the previous year. Over a period of six months, patients were instructed to complete a standardized fall report, noting the circumstances, motor state, presence of freezing of gait, and severity of dyskinesia at the time of each fall. Patients were also divided into three groups according to the severity: severe (Hoehn-Yahr (HY) stage 5 in the Off state), moderate (HY stage 4 in the Off state), and mild (HY stage 1 in the On state, HY stage 3 in the Off state).
Results: Nineteen patients fell predominantly in the On state (classified as On-state fallers), whereas eight patients fell between the On and Off states (Transition-state fallers), and six fell mainly in the Off state. In the severe group (n=10), nine were classified as On-state fallers and one was a Transition-state faller. None of the severe group patients were determined as an Off-state faller. In the moderate group (n=22), 10 were On-state fallers, seven were Transition-state fallers, and five were Off-state fallers. The mild group consists of only one female patient and she was an Off-state faller. For three patients, it was not possible to determine in which motor state they predominantly fell.
Conclusion: PD patients with motor fluctuations mostly fell when their HY stage was between 2 and 4, but did not fall frequently when they were in HY stage 1 or 5. We consider that a “PD fall zone” may exist.
References: none
To cite this abstract in AMA style:
Y. Okuma. Relationship between falls and motor state in Parkinson’s disease patients with motor fluctuations [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/relationship-between-falls-and-motor-state-in-parkinsons-disease-patients-with-motor-fluctuations/. Accessed November 21, 2024.« Back to 2022 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-between-falls-and-motor-state-in-parkinsons-disease-patients-with-motor-fluctuations/