Falls and Parkinson's Disease: Evidence from Video Recordings of Actual Fall Events.

OBJECTIVES: To compare the fall characteristics of individuals with and without Parkinson's disease (PD) through the analysis of real-life falls captured on video.

DESIGN: Observational cohort study.

SETTING: Two long-term care facilities in British Columbia, Canada.

PARTICIPANTS: Individuals living in long-term care (N=306; 16 with PD).

MEASUREMENTS: Falls captured on video and analyzed (N=906; 71 in participants with PD). Generalized estimating equation models were used to examine differences in fall characteristics between participants with and without PD.

RESULTS: Individuals with PD were 1.3 times as likely as those without PD to fall because of incorrect weight shifting (95% confidence interval (CI)=1.03-1.65). Secondary steps during the fall event were 1.5 times as likely to be short in individuals with PD as in those without (95% CI=1.23-1.78). Individuals with PD were also 1.6 times as likely to attempt to recover balance by reaching to grasp an external object (95% CI=1.13-2.15) and 5.0 times as likely to secure grasp of the object (95% CI=1.23-20.0).

CONCLUSION: Along with greater likelihood for individuals with PD to fall because of incorrect weight shifting, differences between groups were found in reactive stepping responses. This first detailed evidence of the characteristics of falls in PD should help to inform fall and injury prevention approaches for clinicians and rehabilitation professionals working with individuals with PD.