Davenport, MJ; East Tennessee State University, Johnson City, TN and Veterans Administration Medical Center, Mountain Home, TN. Davenpom@ETSU.edu.

PURPOSE: Since falls are a frequent and potentially debilitating event for patients with Parkinson’s disease (PD), the application of a fall-risk assessment was studied. BACKGROUND: A variety of tests have been employed in an attempt to evaluate a patient’s risk of falling so that timely therapeutic intervention might be instituted. Although currently used tests measure static and/or dynamic balance, it was thought that dynamic assessment using computerized long forceplate (LFP) technology might offer advantages over other tests and was chosen for evaluation in a pilot study with patients with PD. SUBJECTS: Twenty-two community dwelling adults, 12 with and 10 without PD, were studied. Those with PD were further divided into those with a history of one or more falls within the previous 6 months (6) and those without such history (6). METHODS: Each participant completed three trials of different functional activities on the LFP of the Smart Balance Master (Neurocom). Several parameters were measured. Each subject completed 4 separate activities; they 1) rose from a seated position, 2) walked 1.5 meters, 3) turned 180 degrees, and 4) stepped onto and then over a 4 inch block. Multiple measurements were made during the completion of each activity. ANALYSIS: One-way ANOVA was employed to find if differences were present between any of the three groups, while post hoc Mann-Whitney analyses were carried out to determine between which groups those differences existed. RESULTS: Of those parameters measured, four gave results that were significantly different enough (p £ .05) to allow differentiation between those patients with PD who had a history of falls and those who did not. Weight transfer and rising index while standing from a seated position as well as turn time and turn sway during a 180 degree turn were all significantly different (p £ .05) when comparing those with PD and a history of falls with those patients without such history. Other measured parameters distinguished each group of Parkinsonian patients from controls but not from each other. CONCLUSIONS: The results indicate that dynamic assessment using the LFP is a useful clinical tool for the determination of fall-risk in patients with PD. Furthermore, four test results allowed the distinction to be made between patients with a history of falls and those without. Further research will allow graded responses to be made and the influence of other fall-risk factors to be evaluated. FUNDING SOURCE: ETSU Research Development Award.

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