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123 GAIT AND BALANCE INITIATIVE (GABI): GENDER DIFFERENCES IN RISK AND FREQUENCY OF FALLS
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Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
122 IS THERE A RELATION BETWEEN THE WAY PSYCHIATRIC PATIENTS PERCEIVE AND EXPERIENCE THEIR BODY AND THE WAY THEY WALK? A.K. Wanvik1 , A.-K. Stensdotter1,2 , N. Pedersen3 . 1 Department of Health and Social Work, Physiotherapy, 2 Sør-Trøndelag University College, 3 Østmarka University Hospital, Trondheim, Norway Background: Clinical assessment by physiotherapists working with psychiatric patients claims that both active and passive body movements are closely related to the psychological condition of the patients. Aim: To explore the relationship between gait patterns, self perception and experience of own body in psychiatric patients. Method: Movement was clinically assessed in psychiatric patients and healthy controls with the Comprehensive Body Examination. Body attitude were examined with an adjusted Body Attitude Test (BAT) and self perception with Qualitative Life World Interview. The sum scores from BAT will be compared within and between groups. The interviews were transcribed and analyzed according to Giorgi’s phenomenological method. This study is parallel with the abstract of Stensdotter et al. for this conference. Results: Compared with healthy controls, the patients seemed to walk with a weak toe push-off, less trunk rotation and less arm swing. The patients reported more pain in different parts of the body, and anxiety related to somatic experiences like the body disappearing. They expressed concern about control, and fear of emotions arising in the body. Bodily dissatisfaction and a strong wish to change their body were widespread among patients. Their movement practice was limited and so was their social life. They spent much time sitting or lying and reported little pleasure related to their bodies. Conclusion: Examinations are in process, and it is too early to conclude how self perception and body experience relates to body movement. More data and a conclusion will be presented in February 2010. 123 GAIT AND BALANCE INITIATIVE (GABI): GENDER DIFFERENCES IN RISK AND FREQUENCY OF FALLS C. Wielinski1 , S. Parashos1 , C. Erickson-Davis2 , R. Wichmann1 , S. Lenarz1 , S. Richter3 . 1 Struthers Parkinson’s Center, Park Nicollet Health Services, Golden Valley, MN, 2 GH Sergievsky Center, Columbia University, New York, NY, 3 Melrose Institute, Park Nicollet Health Services, St. Louis Park, MN, USA Background and Aims: To evaluate gender differences in risk and frequency of falls in Parkinson’s disease (PD). Methods: Subjects kept track of falls and near falls for a fourweek period. After completion, subjects completed self-assessment tools and clinical evaluations to assess factors associated with falls in PD (specifically, Berg Balance Scale [BBS], Activities-specific Balance Confidence Scale [ABC-Sum], Beck Anxiety Inventory [BAI]). Numbers of falls and near falls were used as separate outcome measures. Descriptive statistics were calculated and significance was tested for gender differences using Mann–Whitney–Wilcoxon for BAI, BBS, Falls, Near Falls, and Total Events, and 2-sample t-tests for ABC-Sum. Significance was set at p < 0.05. Results: 391 subjects enrolled in the study with 343 completing (88%; 54% male). There were no significant gender differences in age (male, 71.5±8.6; female, 71.6±9.4) or disease duration (males, 9.7±7.0; females, 9.7±6.5). Significant differences were found for BAI (males, 14.4±8.8; females, 17.6±10.5, p = 0.003), ABC-Sum (males, 100.1±36.4; females, 87.0±36.0; p = 0.004), and BBS (males, 44.2±12.1; females, 41.8±12.2; p = 0.010). No significant differences were found for falls (males, 2.3±5.9; females, 1.9±3.4), near falls (males, 3.2±5.1; females, 3.0±6.2), and total events (males, 5.5±8.4; females, 5.0±7.1).
Conclusions: Risk factors commonly associated with falls and near falls in Parkinson’s disease are significantly higher in females compared to males. This increased risk does not result in a greater number of falls, near falls, or total falls/near falls for females. It is unclear why increased risk does not translate into increased events for females. Possible explanations include less active lifestyles, reduced risk-taking activities, or increased awareness or caution. 124 GAIT AND BALANCE INITIATIVE (GABI): INTERACTION OF ANXIETY, BALANCE CONFIDENCE AND BALANCE WITH FALLS AND NEAR FALLS C. Wielinski1 , S. Parashos1 , C. Erickson-Davis2 , R. Wichmann1 , S. Lenarz1 , S. Richter3 . 1 Struthers Parkinson’s Center, Park Nicollet Health Services, Golden Valley, MN, 2 GH Sergievsky Center, Columbia University, New York, NY, 3 Melrose Institute, Park Nicollet Health Services, St. Louis Park, MN, USA Background and Aims: Gait impairment in Parkinson’s disease (PD) is a multifactorial problem. This study explores the relationships between anxiety, balance confidence, and balance, and their association with falls and near falls. Methods: A study of PD patients with Hoehn–Yahr stage 2.5–4 was conducted to improve understanding of gait and balance in PD. Subjects tracked falls and near falls for 4 weeks. Assessments were completed after tracking and include Beck Anxiety Inventory (BAI), Activities-specific Balance Confidence (ABC-Sum), and Berg Balance Scale (BBS). Number of falls and near falls were used as separate outcome measures. Associations were tested using Pearson correlation coefficients (CC), with p < 0.01. Results: 391 subjects enrolled with 343 completing (88%; 54% male). Age was 71.4±9.3 years; disease duration was 10.0±6.9. Age correlated with ABC-Sum (CC = −0.216, p < 0.001) and BBS (CC = −0.357, p < 0.001) but not with BAI, Falls or Near Falls. Disease duration correlated with ABC-Sum (CC = −0.169, p = 0.002), BBS (CC = −0.192, p = 0.001) and Falls (CC = 0.141, p = 0.01) but not with BAI and Near Falls. BAI correlated with ABC-Sum (CC = −0.391, p < 0.001) but not with Falls or Near Falls. ABC-Sum correlated with BBS (CC = 0.648, p < 0.001), Falls (CC = −0.170, p = 0.002) and Near Falls (CC = −0.146, p = 0.009). BBS correlated with Falls (CC = −0.219, p < 0.001) but not with Near Falls. Conclusions: Falls were associated with disease duration, BBS and ABC-Sum. Near Falls were only associated with ABC-Sum. BAI, BBS and ABC-Sum were highly correlated with each other. 125 GAIT AND BALANCE INITIATIVE (GABI): PHENOMENOLOGY OF FALLS IN PARKINSON’S DISEASE (PD) C. Wielinski1 , S. Parashos1 , C. Erickson-Davis2 , S. Lenarz1 . 1 Struthers Parkinson’s Center, Park Nicollet Health Services, Golden Valley, MN, 2 GH Sergievsky Center, Columbia University, New York, NY, USA Background and Aims: Falling is a frequent problem in PD patients, often leading to morbidity. This abstract describes attributes and associated symptoms of falls and near falls in PD. Methods: PD patients kept a falls diary for a four-week period. For their first ten events detailed information was collected. Additional events were recorded as fall or near fall with a brief description. Descriptive statistics were calculated and associations analyzed using Chi-square statistic. Results: Of the 338 PD patients completing the diaries, 69 (20%) of the subjects had no events, while 269 reported a total of 1,833 events (41% falls and 59% near falls); 85 (32%) experienced only near falls, and 45 (17%) only falls. Detailed information was available for 1,382 events. Direction of fall was 45% forwards, 26% backwards, 29% sideways; backwards was more common in falls (p < 0.001) and sideways more common in near falls (p = 0.03). Associated symptoms included wearing off (27%), fatigue (24%), freezing (21%), dizziness (15%),
Posters / Parkinsonism and Related Disorders 16S1 (2010) S11–S86
122 IS THERE A RELATION BETWEEN THE WAY PSYCHIATRIC PATIENTS PERCEIVE AND EXPERIENCE THEIR BODY AND THE WAY THEY WALK? A.K. Wanvik1 , A.-K. Stensdotter1,2 , N. Pedersen3 . 1 Department of Health and Social Work, Physiotherapy, 2 Sør-Trøndelag University College, 3 Østmarka University Hospital, Trondheim, Norway Background: Clinical assessment by physiotherapists working with psychiatric patients claims that both active and passive body movements are closely related to the psychological condition of the patients. Aim: To explore the relationship between gait patterns, self perception and experience of own body in psychiatric patients. Method: Movement was clinically assessed in psychiatric patients and healthy controls with the Comprehensive Body Examination. Body attitude were examined with an adjusted Body Attitude Test (BAT) and self perception with Qualitative Life World Interview. The sum scores from BAT will be compared within and between groups. The interviews were transcribed and analyzed according to Giorgi’s phenomenological method. This study is parallel with the abstract of Stensdotter et al. for this conference. Results: Compared with healthy controls, the patients seemed to walk with a weak toe push-off, less trunk rotation and less arm swing. The patients reported more pain in different parts of the body, and anxiety related to somatic experiences like the body disappearing. They expressed concern about control, and fear of emotions arising in the body. Bodily dissatisfaction and a strong wish to change their body were widespread among patients. Their movement practice was limited and so was their social life. They spent much time sitting or lying and reported little pleasure related to their bodies. Conclusion: Examinations are in process, and it is too early to conclude how self perception and body experience relates to body movement. More data and a conclusion will be presented in February 2010. 123 GAIT AND BALANCE INITIATIVE (GABI): GENDER DIFFERENCES IN RISK AND FREQUENCY OF FALLS C. Wielinski1 , S. Parashos1 , C. Erickson-Davis2 , R. Wichmann1 , S. Lenarz1 , S. Richter3 . 1 Struthers Parkinson’s Center, Park Nicollet Health Services, Golden Valley, MN, 2 GH Sergievsky Center, Columbia University, New York, NY, 3 Melrose Institute, Park Nicollet Health Services, St. Louis Park, MN, USA Background and Aims: To evaluate gender differences in risk and frequency of falls in Parkinson’s disease (PD). Methods: Subjects kept track of falls and near falls for a fourweek period. After completion, subjects completed self-assessment tools and clinical evaluations to assess factors associated with falls in PD (specifically, Berg Balance Scale [BBS], Activities-specific Balance Confidence Scale [ABC-Sum], Beck Anxiety Inventory [BAI]). Numbers of falls and near falls were used as separate outcome measures. Descriptive statistics were calculated and significance was tested for gender differences using Mann–Whitney–Wilcoxon for BAI, BBS, Falls, Near Falls, and Total Events, and 2-sample t-tests for ABC-Sum. Significance was set at p < 0.05. Results: 391 subjects enrolled in the study with 343 completing (88%; 54% male). There were no significant gender differences in age (male, 71.5±8.6; female, 71.6±9.4) or disease duration (males, 9.7±7.0; females, 9.7±6.5). Significant differences were found for BAI (males, 14.4±8.8; females, 17.6±10.5, p = 0.003), ABC-Sum (males, 100.1±36.4; females, 87.0±36.0; p = 0.004), and BBS (males, 44.2±12.1; females, 41.8±12.2; p = 0.010). No significant differences were found for falls (males, 2.3±5.9; females, 1.9±3.4), near falls (males, 3.2±5.1; females, 3.0±6.2), and total events (males, 5.5±8.4; females, 5.0±7.1).
Conclusions: Risk factors commonly associated with falls and near falls in Parkinson’s disease are significantly higher in females compared to males. This increased risk does not result in a greater number of falls, near falls, or total falls/near falls for females. It is unclear why increased risk does not translate into increased events for females. Possible explanations include less active lifestyles, reduced risk-taking activities, or increased awareness or caution. 124 GAIT AND BALANCE INITIATIVE (GABI): INTERACTION OF ANXIETY, BALANCE CONFIDENCE AND BALANCE WITH FALLS AND NEAR FALLS C. Wielinski1 , S. Parashos1 , C. Erickson-Davis2 , R. Wichmann1 , S. Lenarz1 , S. Richter3 . 1 Struthers Parkinson’s Center, Park Nicollet Health Services, Golden Valley, MN, 2 GH Sergievsky Center, Columbia University, New York, NY, 3 Melrose Institute, Park Nicollet Health Services, St. Louis Park, MN, USA Background and Aims: Gait impairment in Parkinson’s disease (PD) is a multifactorial problem. This study explores the relationships between anxiety, balance confidence, and balance, and their association with falls and near falls. Methods: A study of PD patients with Hoehn–Yahr stage 2.5–4 was conducted to improve understanding of gait and balance in PD. Subjects tracked falls and near falls for 4 weeks. Assessments were completed after tracking and include Beck Anxiety Inventory (BAI), Activities-specific Balance Confidence (ABC-Sum), and Berg Balance Scale (BBS). Number of falls and near falls were used as separate outcome measures. Associations were tested using Pearson correlation coefficients (CC), with p < 0.01. Results: 391 subjects enrolled with 343 completing (88%; 54% male). Age was 71.4±9.3 years; disease duration was 10.0±6.9. Age correlated with ABC-Sum (CC = −0.216, p < 0.001) and BBS (CC = −0.357, p < 0.001) but not with BAI, Falls or Near Falls. Disease duration correlated with ABC-Sum (CC = −0.169, p = 0.002), BBS (CC = −0.192, p = 0.001) and Falls (CC = 0.141, p = 0.01) but not with BAI and Near Falls. BAI correlated with ABC-Sum (CC = −0.391, p < 0.001) but not with Falls or Near Falls. ABC-Sum correlated with BBS (CC = 0.648, p < 0.001), Falls (CC = −0.170, p = 0.002) and Near Falls (CC = −0.146, p = 0.009). BBS correlated with Falls (CC = −0.219, p < 0.001) but not with Near Falls. Conclusions: Falls were associated with disease duration, BBS and ABC-Sum. Near Falls were only associated with ABC-Sum. BAI, BBS and ABC-Sum were highly correlated with each other. 125 GAIT AND BALANCE INITIATIVE (GABI): PHENOMENOLOGY OF FALLS IN PARKINSON’S DISEASE (PD) C. Wielinski1 , S. Parashos1 , C. Erickson-Davis2 , S. Lenarz1 . 1 Struthers Parkinson’s Center, Park Nicollet Health Services, Golden Valley, MN, 2 GH Sergievsky Center, Columbia University, New York, NY, USA Background and Aims: Falling is a frequent problem in PD patients, often leading to morbidity. This abstract describes attributes and associated symptoms of falls and near falls in PD. Methods: PD patients kept a falls diary for a four-week period. For their first ten events detailed information was collected. Additional events were recorded as fall or near fall with a brief description. Descriptive statistics were calculated and associations analyzed using Chi-square statistic. Results: Of the 338 PD patients completing the diaries, 69 (20%) of the subjects had no events, while 269 reported a total of 1,833 events (41% falls and 59% near falls); 85 (32%) experienced only near falls, and 45 (17%) only falls. Detailed information was available for 1,382 events. Direction of fall was 45% forwards, 26% backwards, 29% sideways; backwards was more common in falls (p < 0.001) and sideways more common in near falls (p = 0.03). Associated symptoms included wearing off (27%), fatigue (24%), freezing (21%), dizziness (15%),