Rapid assessment of postural instability in Parkinson’s disease (RAPID): a pilot study
Article first published online: 24 JUN 2010
© 2010 The Author(s). European Journal of Neurology © 2010 EFNS
European Journal of Neurology
Volume 18, Issue 2, pages 260–265, February 2011
How to Cite
Chong, R. K. Y., Morgan, J., Mehta, S. H., Pawlikowska, I., Hall, P., Ellis, A. V., Ibanez-Wong, A. D., Miller, G. M., Baugh, K. and Sethi, K. (2011), Rapid assessment of postural instability in Parkinson’s disease (RAPID): a pilot study. European Journal of Neurology, 18: 260–265. doi: 10.1111/j.1468-1331.2010.03115.x
- Issue published online: 17 JAN 2011
- Article first published online: 24 JUN 2010
- Received 20 January 2010 Accepted 10 May 2010
- fear of falling;
- pull test;
Background: The Fahn’s pull (or retropulsion) test is an item in the motor section of the Unified Parkinson’s Disease Rating Scale, which is used almost exclusively to classify postural instability in Parkinson’s disease (PD). However, the test is hard to standardize and is often performed incorrectly, making it hard to interpret. Moreover, it may not be safe to administer in patients who experience pain in the shoulders, neck, trunk and/or lower extremities. Identifying and grading postural instability in PD without requiring a physical challenge would not only be useful for the clinician but would assist patients and caregivers in its recognition. We propose the use of the rapid assessment of postural instability in Parkinson’s disease (RAPID) questionnaire as a non-physical assessment tool.
Methods: We determined the associations between the pull test and items on a risk-assessment questionnaire that consisted of three parts: activities of daily living, fear of falling, and frequency of falling.
Results: Significant correlations were found between the pull test and the predictor variables, which ranged between 0.51 and 0.56 whilst the correlations amongst the predictor variables ranged between 0.58 and 0.70. The three parts of the questionnaire, when used in combination, produced a 96% sensitivity in the classification of postural instability.
Conclusions: The RAPID questionnaire can be used as an adjunct to the pull test or solely if the pull test is contraindicated. It may also be possible to administer the questionnaire via the telephone or Internet. It is hoped that the rapid identification of postural instability would lead to fewer falls.