TY - JOUR
T1 - Prevention of Falls in Parkinson's Disease
T2 - Guidelines and Gaps
AU - Camicioli, Richard
AU - Morris, Meg E.
AU - Pieruccini-Faria, Frederico
AU - Montero-Odasso, Manuel
AU - Son, Surim
AU - Buzaglo, David
AU - Hausdorff, Jeffrey M.
AU - Nieuwboer, Alice
N1 - Publisher Copyright:
© 2023 The Authors. Movement Disorders Clinical Practice published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
PY - 2023/10
Y1 - 2023/10
N2 - Background: People living with Parkinson's disease (PD) have a high risk for falls. Objective: To examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults. Methods: A Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention. Results: A recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi-domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels. Conclusion: Effective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.
AB - Background: People living with Parkinson's disease (PD) have a high risk for falls. Objective: To examine gaps in falls prevention targeting people with PD as part of the Task Force on Global Guidelines for Falls in Older Adults. Methods: A Delphi consensus process was used to identify specific recommendations for falls in PD. The current narrative review was conducted as educational background with a view to identifying gaps in fall prevention. Results: A recent Cochrane review recommended exercises and structured physical activities for PD; however, the types of exercises and activities to recommend and PD subgroups likely to benefit require further consideration. Freezing of gait, reduced gait speed, and a prior history of falls are risk factors for falls in PD and should be incorporated in assessments to identify fall risk and target interventions. Multimodal and multi-domain fall prevention interventions may be beneficial. With advanced or complex PD, balance and strength training should be administered under supervision. Medications, particularly cholinesterase inhibitors, show promise for falls prevention. Identifying how to engage people with PD, their families, and health professionals in falls education and implementation remains a challenge. Barriers to the prevention of falls occur at individual, environmental, policy, and health system levels. Conclusion: Effective mitigation of fall risk requires specific targeting and strategies to reduce this debilitating and common problem in PD. While exercise is recommended, the types and modalities of exercise and how to combine them as interventions for different PD subgroups (cognitive impairment, freezing, advanced disease) need further study.
KW - Parkinson's disease
KW - accidental falls
KW - exercise
KW - falls
KW - freezing
KW - gait speed
UR - http://www.scopus.com/inward/record.url?scp=85169611981&partnerID=8YFLogxK
U2 - 10.1002/mdc3.13860
DO - 10.1002/mdc3.13860
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C2 - 37868930
AN - SCOPUS:85169611981
SN - 2330-1619
VL - 10
SP - 1459
EP - 1469
JO - Movement Disorders Clinical Practice
JF - Movement Disorders Clinical Practice
IS - 10
ER -