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External validation of a 3-step falls prediction model in mild Parkinson’s disease
Lund University.
Lund University.
Lund University.
Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Platform for Collaboration for Health. (PRO-CARE)ORCID iD: 0000-0003-2174-372X
2016 (English)In: Journal of Neurology, ISSN 0340-5354, E-ISSN 1432-1459, Vol. 263, no 12, 2462-2469 p.Article in journal (Refereed) Published
Abstract [en]

The 3-Step Falls Prediction Model (3-step model) that include history of falls, history of freezing of gait and comfortable gait speed <1.1m/s was suggested as a clinical fall prediction tool in Parkinson’s disease (PD). We aimed to externally validate this model as well as to explore the value of additional predictors in 138 individuals with relatively mild PD. We found the discriminative ability of the 3–step model in identifying fallers to be comparable to previously studies (area under curve (AUC), 0.74; 95%CI, 0.65-0.84) and to be better than that of single predictors (AUC, 0.61-0.69). Extended analyses generated a new model for prediction of falls and near falls (AUC, 0.82; 95%CI, 0.75-0.89) including history of near falls, retropulsion according to the Nutt Retropulsion Test (NRT) and tandem gait (TG). This study confirms the value of the 3-step model as a clinical falls prediction tool in relatively mild PD and illustrates that it outperforms the use of single predictors. However, to improve future outcomes, further studies are needed to firmly establish a scoring system and risk categories based on this model. The influence of methodological aspects of data collection also needs to be scrutinized. A new model for prediction of falls and near falls, including history of near falls, TG and retropulsion (NRT) may be considered as an alternative to the 3-step model, but needs to be tested in additional samples before being recommended. Taken together, our observations provide important additions to the evidence base for clinical fall prediction in PD. 

Place, publisher, year, edition, pages
2016. Vol. 263, no 12, 2462-2469 p.
Keyword [en]
Parkinson disease, falls, near falls, gait, balance, prediction
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:hkr:diva-15973DOI: 10.1007/s00415-016-8287-9ISI: 000388625500015PubMedID: 27646115OAI: oai:DiVA.org:hkr-15973DiVA: diva2:970597
Available from: 2016-09-14 Created: 2016-09-14 Last updated: 2017-01-11Bibliographically approved

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Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and EducationAvdelningen för Hälsovetenskap IResearch Platform for Collaboration for Health
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CiteExportLink to record
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Citation style
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