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Associations Between Objective, Functional, and Self-Reported Balance Assessments and Fall Frequency in Parkinson's
Senanur Duzenli̇1,2, Ayca Arslanturk Yildirim3,4, Merve Sevinc Gunduz3,4
1Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Bezmialem Vakif University, Istanbul, Türkiye. senanur.duzenli@bezmialem.edu.tr.
Background:
Falls are common in Parkinson's disease (PD) and reduce quality of life. Numerous balance assessment tools evaluate fall risk; however, data on their relationship with fall frequency are limited.
Aims:
To investigate the relationship between fall frequency and objective, functional, and self-reported balance assessment tools in PD patients.
Methods:
This cross-sectional study included 40 PD patients (Hoehn and Yahr stages 1-3). Fall frequency was recorded using a fall diary. Objective balance was assessed with the Biodex Balance System, functional balance with the Mini-Balance Evaluation Systems Test (Mini-BESTest), and perceived balance confidence with the Falls Efficacy Scale-International (FES-I).
Results:
Fall frequency was weakly correlated with the Overall Stability Index (r = 0.338, p = 0.033) and the dynamic gait subdomain of the Mini-BESTest (r = 0.331, p = 0.037) and moderately correlated with FES-I scores (r = 0.572, p < 0.001). Binary logistic regression revealed that the FES-I score was a significant independent predictor of faller status (χ²= 12.41, p < 0.001, Nagelkerke R² = 0.357); each one-point increase in FES-I score increased the odds of being a faller by 15.5% (OR = 1.16, 95% CI: 1.05-1.28, p = 0.005).
Conclusions:
Fall frequency was associated with all balance assessments, with the self-report measure demonstrating a moderate association that was greater in magnitude than those observed for the objective and functional assessments. These findings indicate that clinical evaluation of fall risk should incorporate self-report tools reflecting activity and participation limitations and contextual factors, alongside laboratory-based and functional assessments.
