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Fear of falling and postural control in Parkinson's disease

Authors

  • Allan L. Adkin PhD,

    Corresponding author
    1. Gait and Posture Laboratory, Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
    • Gait and Posture Laboratory, Department of Kinesiology, 200 University Avenue West, University of Waterloo, Waterloo, Ontario, N2L 3G1 Canada
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  • James S. Frank PhD,

    1. Gait and Posture Laboratory, Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
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  • Mandar S. Jog MD, FRCPC

    1. Gait and Posture Laboratory, Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
    2. Movement Disorders Program, Clinical Neurological Sciences, London Health Sciences Centre, London, Ontario, Canada
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Abstract

This study investigated the relationship between fear of falling (FOF) and qualitative and quantitative postural control in Parkinson's disease (PD). Fifty-eight nondemented PD patients were studied along with age-matched healthy controls. The degree of FOF was estimated using the Activities-specific Balance Confidence scale. Qualitative postural control was evaluated using a component of the Unified Parkinson Disease Rating Scale. Postural control was quantified, using centre of pressure measures obtained from a force plate, for eight standing balance tests of different challenges. The results showed that FOF was more evident for PD patients when compared with healthy individuals of similar age. Furthermore, FOF was significantly associated with a qualitative estimate of postural control in PD; individuals with PD who had a greater degree of posture impairment reported greater FOF. The results also showed that an estimate of FOF may help to explain quantitative postural instability in PD. FOF, when coupled with a qualitative estimate of postural control, was able to explain a greater amount of variation in quantitative balance performance for five of the eight balance tests. When considered independently, the qualitative measure of postural control, in general, could not well predict quantitative balance performance. The greater degree of FOF and its possible association with altered postural control suggests that FOF should be considered as an important, independent risk factor in the assessment and treatment of postural instability in patients with PD. © 2003 Movement Disorder Society

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