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Affiliation
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J. Oliveira-Filho, MD, MS, PhD, Postgraduate Program in Health Sciences, Federal University of Bahia School of Medicine. |
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Abstract
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BACKGROUND: Balance confidence and fear of falling are factors associated with recurrent falls in individuals with Parkinson disease (PD). However, the accuracy for falls prediction based on self-report measures has not been widely investigated.
OBJECTIVE: To compare the accuracy of the Activities-specific Balance Confidence Scale (ABC) and Falls Efficacy Scale-International (FES-I) with the Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Functional Reach Test (FRT) and Timed Up and Go (TUG) in identifying recurrent fallers with PD; to explore the ability of combinations of up to three tests to predict recurrent falls.
DESIGN: Prospective cohort study with individuals with PD (n = 225).
METHODS: Participants were assessed with ABC, FES-I, BBS, FRT, TUG and DGI. Those who reported ≥2 falls in the 12-month follow-up period were classified as recurrent fallers. Areas under the ROC curves (AUC) were determined and Akaike information criterion (AIC) was used to select the best predictive model.
RESULTS: Eighty-four (37.3%) participants were classified as recurrent fallers. The AUC for the ABC was 0.73, for the FES-I 0.74 and for the TUG, FRT, DGI and BBS was 0.72, 0.74, 0.76 and 0.79, respectively. Two-test models provided additional discriminating ability when compared to individual measures and had similar AIC as three-test models, particularly BBS with FES-I. LIMITATIONS: There is not an external validation sample.
CONCLUSIONS: ABC and FES-I demonstrated moderate accuracy in predicting recurrent falls, showing similar predictive ability as performance-based balance measures, especially FRT and TUG. Two-test models showed similar performance as three-test models, suggesting that a combination of two measures may improve the predictive ability of recurrent falls in PD. Specifically, the utilization of BBS along with FES-I may be considered.
Language: en |