Fall circumstances in the home environment in people with Parkinson’s disease: An exploration of walking aid users.
Abstract
INTRODUCTION
In the recent falls guidelines, multidomain interventions are recommended for people with Parkinson’s disease (PwP) [PMID:36178003]. Walking aids improve local balance and stability, increase confidence and reduce mechanical effort associated with walking [PMID:20674533], however walking aid use is associated with recurrent falls in PwP [PMID:25095816]. This study aimed to understand pre-fall activity and environmental fall risk in fallers and the differences associated with walking aid use.
METHODS
An online survey was developed to evaluate retrospective falls in adults ≥60y. 117 PwP responded to the survey. The survey covered basic descriptors, walking aid use, fall history (2y) and contextual information about falls.
RESULTS
48 PwPD used a walking aid and of those 43 (90%) had fallen (PDfaller+AID). 69 PwP did not use a walking aid and of those 36 (52%) had fallen (PDfaller-AID). Results are reported for PDfaller+AID and PDfaller-AID. The groups were similar in age and sex. Fear of falling (Short FES-I) was significantly higher in PDfaller+AID (p<0.001).
For PDfaller+AID, the top three pre-fall activities were: turning (72%); walking (63%); and moving too quickly (51%). For PDfaller-AID, the top three pre-fall activities were: turning (67%); moving too quickly (42%); and bending down (31%). For both groups, the top three home environmental risk factors were: objects on the floor; slope/uneven surface; and steps/stairs.
77% of PDfaller+AID were not using their walking aid at the time of the fall. Of these respondents tripping over the door trim/ threshold was most common compared to those who were using their walking aid at the time of the fall who fell on the steps/stairs.
CONCLUSION
Holistic approaches targeting gait and balance in combination with home modifications are required. Despite being prescribed a walking aid, the majority of PDfaller+AID were not using it at the time of the fall. Barriers to using walking aids in the home environment that should be explored.
[1] Montero-Odasso 2022 PMID:36178003 [2] Cetin 2010 PMID:20674533 [3] Canning 2014 PMID:25095816
Comments
Interesting research
If I understand correctly, according to your survey, more fallers used a walking aid than those who didn't. What did you conclude from this statistic? Shouldn't it be the other way round?