Postural disordes and falls risk in patients with parkinson disease: comparison between subjective and objective stability perception

Introduction Parkinson disease increases considerably falls risk due to postural changes, global motility, deambulation and balance. Purpose To correlate self-awareness of falls risk (Falls Risk Assessment System) to the objective risk measured by a validated objective scale (ABC) in patients with Parkinson disease. Material 16 cognitively unimpaired patients with Parkinson disease, able to stand up and walk through a few metres. Setting: Zucchi Clinical Institute, Carate Brianza Italy Methods UPDRS, ABC scale, FOG scale and PPD were administered. Falls risk was evaluated by Falls Risk Assessment System; patients were divided in two groups: high falls risk and very high falls risk based on PPA scale results. Patient falls were monitored during the 2 months prior to the assessment. Results The greater deficit in patients with Parkinson disease were reduced sight acuity, foot reaction time, balance over soft surfaces, low arms strength and freezing of gait. An incresed falls risk was associated with FOG scale and UDPRS scores. The increased falls risk was not associated with PPD and ABC scale scores. Conclusions ABC scale may not be used alone as a reliable scale to assess instability in patients with Parkinson disease, it should always be associated with an objective examination. Falls Risk Assessment is an excellent and innovative tool for an objective evaluation of falls risk. Assessing stability parameters and deficits in patients with Parkinson disease with an objective tool is important for the rehabilitation program. Modified testing exercise might be used for treatment which aims to improve deficits and making patients aware of their own stability.