Parkinson disease.

Area of Science:

• Neurology
• Movement Disorders
• Geriatrics

Background:

• Parkinson disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms.
• Gait disturbance, balance problems, and falls are prevalent and progressive issues in PD patients.
• Freezing of gait (FOG) is a particularly disabling feature, increasing with disease duration.

Purpose of the Study:

• To review the clinical, pathologic, and physiologic aspects of gait disturbance and falls in PD.
• To examine the evidence supporting various medical and non-medical interventions for improving gait and reducing falls in PD.

Main Methods:

• Literature review of clinical, pathologic, and physiologic correlates of gait and falls in PD.
• Analysis of evidence for therapeutic interventions, including pharmacologic and non-pharmacologic approaches.

Main Results:

• Falls are common in PD, with a high rate of recurrence.
• Identified risk factors for falls include history of falls, FOG, impaired balance, reduced leg strength, mobility deficits, cognitive impairment, and fear of falling.
• Interventions such as levodopa, deep-brain stimulation, cuing strategies, and exercise show potential for improving physical function and mobility.

Conclusions:

• Gait disturbance and falls are significant challenges in Parkinson disease management.
• A multifactorial approach addressing identified risk factors and utilizing available therapies is crucial for enhancing patient mobility and safety.