Session Information
Date: Tuesday, June 21, 2016
Session Title: Parkinson's disease: Pathophysiology
Session Time: 12:30pm-2:00pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To determine if step length influence falls in Parkinson’s disease (PD) patients.
Background: Falls are major cause of disability in PD. The objective of this study is to determine if short step and slow step velocity can cause falls.
Methods: We did retrospective analysis of 460 PD patients seen at Muhammad Ali Parkinson center. Demographic and clinical information collected include age, duration of PD, medications, Unified Parkinson’s disease Rating Scale (UPDRS) scores, gait length and velocity, incidence of freezing of gait, and occurrence of serious fall.
Results: Of the PD patients, 204 (50.5%) fell and 200 (49.5%) did not fall. Of the 204 fallers, 71 (34.8%) fell more than once. Fallers were significantly older than non-fallers (72.6±5.8 versus 66.9±6.1 years) and fallers had PD significantly longer (9.3±3.7 versus 5.4±2.2 years), significantly higher (worse) UPDRS motor scores (29.3±10.9 versus 18.9±8.3), significantly higher (worse) UPDRS axial scores (9.2±3.5 versus 5.1±2.7), significantly shorter steps (0.45± 0.09 versus 0.60±0.13 meter), and slower velocity (0.75±0.21 versus 0.90±0.31 m/s) compared with non-fallers. Fallers were also significantly more likely to have freezing of gait (21.1%) than non- fallers (10.5%) (OR,2.28; 95% Confidence Interval, 1.30-3.99; p<0.004). Among 204 fallers, 84% were on levodopa and among 200 non-fallers, 80% were on levodopa.
| Variable | Non-fallers | Fallers | p Value[dagger] |
|---|---|---|---|
| Age (years) | 66.9 ± 6.1 | 72.6 ± 5.8 | 0.019 |
| PD duration (years) | 5.4 ± 2.2 | 9.3 ± 3.7 | 0.003 |
| MDS-UPDRS motor score | 18.9 ± 8.3 | 29.3 ± 10.9 | <0.001 |
| MDS-UPDRS axial score | 5.1 ± 2.7 | 9.2 ± 3.5 | <0.001 |
| Step length (m/step) | 0.60 ± 0.13 | 0.45 ± 0.09 | <0.001 |
| Step velocity (m/sec) | 0.75 ± 0.21 | 0.90 ± 0.31 | <0.001 |
Conclusions: In our study, fallers took significantly shorter and slower steps than non-fallers. This "cautious" gait may be an inappropriate adaption to impaired balance. Small and short steps may create a "mismatch" between the speed and displacement of the upper versus the lower body, resulting in the upper body "tipping over" and the patient falling. Education, exercise, and gait and balance training that focus on increasing step length and velocity may reduce falls.
Will be Presented at AAN 2016 meeting.
To cite this abstract in AMA style:
A. Lieberman, A. Deep, S. Shafer, T. Lockhart. Falls in Parkinson’s disease: Beware the short, slow steps [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/falls-in-parkinsons-disease-beware-the-short-slow-steps/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/falls-in-parkinsons-disease-beware-the-short-slow-steps/