Falls classification in Parkinson’s disease: a new approach
Recurrent falls can be challenging to manage with 60% of people with Parkinson's disease (PD) falling at least once per year. There are over 400 falls risk factors and classification according to falls frequency alone potentially lacks sensitivity to predict other falls risk factors. The study modified the FRAC to allow a greater understanding of prefall activity which could be used to identify an effective falls management strategy which is more individualised.
The original FRAC definitions were modified for the study. Falls were categorised by everyday tasks of increasing complexity completed at the time of the fall. Transfers/ changes in posture were categorised as ‘transitional’, everyday walking activities such as walking and carrying objects were ’combined’ and complex motor tasks including hill walking or skiing classified as ‘advanced’.
The study reported on inter-rater reliability (IRR) of the modified FRAC scale for people with incident idiopathic Parkinsons disease. 23 raters consisting of 3 clinical subgroups with clustered falls expertise rated 55 fall scenarios using the FRAC without formal training. Results demonstrated excellent IRR.
Falls are a major cause of disability and one of the leading causes of mortality for older adults highlighting the need for effective falls prevention. The authors report the FRAC is easy to use can be completed without formal training and with further research could potentially be applied to other populations of fallers and completed by various disciplines.
> From: Ross et al., Physiotherapy 103 (2017-12-20 07:27:47) 459-464. All rights reserved to Elsevier Ltd. Click here for the online summary.