Landers MR, Wallmann HW; Department of Physical Therapy, University of Nevada, Las Vegas. Merrill.Landers@ccmail.nevada.edu.

PURPOSE: Postural instability is a common impairment in idiopathic Parkinson’s disease (PD). It is associated with considerable functional limitation and disability, and its consequences can lead to morbidity and even mortality. Being able to differentiate between those at risk for falling and those with no risk is an important aspect in the clinical examination of the patient with PD. Therefore, the purpose of this study was to determine if two commonly used assessment tools, computerized dynamic posturography (CDP) and the PDQ-39, could differentiate between fallers and non-fallers. SUBJECTS: Twenty-two patients all diagnosed with idiopathic Parkinson’s disease were recruited to participate in this study. Subjects were then divided into two groups, 10 reporting a history of falls within the last year (Hoehn and Yahr Stage III) and 12 without such a history (Stage II). METHODS: Each subject reported a history of falls within the last year and completed the PDQ-39. Subjects reporting a history of falls within the last year were operationally defined as fallers. Subjects were then tested on three limits of stability conditions using the NeuroCom^® Smart Balance Master system. ANALYSIS: Independent samples t-tests were used to examine the differences between the fallers and non-fallers. RESULTS: Of the parameters measured, three PDQ-39 subscale scores (Activities of daily living (ADLs), mobility, and communication) gave results that were significant to discriminate between those patients with PD and a history of falls with patients without such a history (p < .05). There were no statistically significant differences found for the other PDQ-39 subscale scores (emotional well-being, stigma, social support, cognitive impairment, and bodily discomfort) or for any of the three balance master conditions. CONCLUSION: Results indicate that the PDQ-39 may be a useful standardized assessment tool to help discriminate differences between fallers and non-fallers in two movement-related subscale measures, ADLs and mobility. However, no differences were noted in those with and without a history of falls under the three balance master conditions. Results from this study warrant further investigation using larger sample sizes. FUNDING SOURCE: None.

Copyright 2004 by the American Physical Therapy Association

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