Safer mobility behaviour for fall prevention in Parkinson’s disease: A scoping review

Introduction

Falls are a devastating issue with compounded effects for people with Parkinson’s disease (PwPD). Promoting safer mobility behaviour may reduce falls however this concept has been poorly articulated. Furthermore, whilst some components of relevant assessment and intervention have been reported, this approach has not been holistically outlined. This scoping review aims to map out the existing literature on the conceptualisation of safer mobility behaviour and how it is assessed and promoted, with implications drawn for PwPD living in the community. 

Methods

The review was conducted in accordance with The Joanna Briggs Institute’s methodology. Studies involving older adults (aged ≥65 years) and/or PwPD in home and community settings were included. Studies that sought to define, describe, and/or explain safer mobility behaviour were included. Assessment tools with >50% items assessing mobility behaviour and interventions with one or more components targeting safer mobility behaviour were included.

Results

A total of 136 publications were included. Whilst safer mobility behaviour was not explicitly defined, its performance was described as a combination of observable actions and cognitive processes. Mobility behaviour was influenced by a dynamic interaction between person (physical, cognitive and affective domains), task and environmental related factors. Ten assessment tools were identified that assessed behavioural strategies to reduce falls or fear of falling avoidance behaviour. However, none were specifically designed for PwPD. Seven out of 16 interventions were designed for PwPD involving education and movement strategy training.

Conclusions

This study provides the conceptual framework for safer mobility behaviour and how it is assessed and improved for older adults and PwPD. Mobility behaviour is unique to the individual and sits on a continuum of riskier to safer behaviour. Future assessment tools and interventions for PwPD should be tailored to address the heterogeneity and progression of Parkinson’s disease.