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Open Access Research article

Factors associated with fear of falling in people with Parkinson’s disease

Beata Lindholm13, Peter Hagell2, Oskar Hansson3 and Maria H Nilsson4*

Author Affiliations

1 Department of Neurology, Skåne University Hospital, Malmö, Sweden

2 The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden

3 Department of Clinical Sciences, Lund University, Malmö, Sweden

4 Department of Health Sciences, Lund University, Box 157, Lund SE-221 00, Sweden

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BMC Neurology 2014, 14:19  doi:10.1186/1471-2377-14-19

Published: 24 January 2014

Abstract

Background

This study aimed to comprehensibly investigate potential contributing factors to fear of falling (FOF) among people with idiopathic Parkinson’s disease (PD).

Methods

The study included 104 people with PD. Mean (SD) age and PD-duration were 68 (9.4) and 5 (4.2) years, respectively, and the participants’ PD-symptoms were relatively mild. FOF (the dependent variable) was investigated with the Swedish version of the Falls Efficacy Scale, i.e. FES(S). The first multiple linear regression model replicated a previous study and independent variables targeted: walking difficulties in daily life; freezing of gait; dyskinesia; fatigue; need of help in daily activities; age; PD-duration; history of falls/near falls and pain. Model II included also the following clinically assessed variables: motor symptoms, cognitive functions, gait speed, dual-task difficulties and functional balance performance as well as reactive postural responses.

Results

Both regression models showed that the strongest contributing factor to FOF was walking difficulties, i.e. explaining 60% and 64% of the variance in FOF-scores, respectively. Other significant independent variables in both models were needing help from others in daily activities and fatigue. Functional balance was the only clinical variable contributing additional significant information to model I, increasing the explained variance from 66% to 73%.

Conclusions

The results imply that one should primarily target walking difficulties in daily life in order to reduce FOF in people mildly affected by PD. This finding applies even when considering a broad variety of aspects not previously considered in PD-studies targeting FOF. Functional balance performance, dependence in daily activities, and fatigue were also independently associated with FOF, but to a lesser extent. Longitudinal studies are warranted to gain an increased understanding of predictors of FOF in PD and who is at risk of developing a FOF.

Keywords:
Fear of falling; Physical therapy; Parkinson’s disease; Postural Balance; Rehabilitation