A simple question about falls to distinguish balance and gait difficulties in Parkinson's disease

Int J Neurosci. 2012 Dec;122(12):710-5. doi: 10.3109/00207454.2012.711399. Epub 2012 Aug 21.

Abstract

Although gait and balance difficulties often occur together in Parkinson's disease (PD) patients, it is believed that they are actually two eparate symptoms. However, there are no simple tests to distinguish them. We have developed the self-administered Barrow Neurological Institute (BNI) question to distinguish between gait and balance issues in PD and it was tested in 102 consecutive PD patients. The responses were compared with those of the walking and balance question (item # 2.12) of the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), and the MDS-UPDRS motor examination and its subsets such as gait and postural stability (PS). Fifty-five patients reported balance difficulty on the BNI question and 64 reported walking and balance difficulty on the MDS-UPDRS question. Of the patients who reported balance difficulty on the BNI question, 74.5% had a PS score ≥2 and 25.4% fell at least three times per month. Of the patients who reported walking and balance difficulty on the MDS-UPDRS question, only 59.4% had a PS score ≥2 and only 10.9% fell three or more times per month. These statistically significant results suggest that the BNI question is better able to detect balance difficulty and its associated falls in PD and can be a supplement to the MDS-UPDRS or a stand-alone question to evaluate balance difficulty and its associated falls in PD.

Publication types

  • Comparative Study

MeSH terms

  • Accidental Falls*
  • Aged
  • Aged, 80 and over
  • Disability Evaluation
  • Female
  • Gait Disorders, Neurologic / diagnosis*
  • Gait Disorders, Neurologic / etiology*
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / complications*
  • Postural Balance / physiology*
  • Sensation Disorders / diagnosis*
  • Sensation Disorders / etiology*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Walking / physiology