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Various clinical tests and balance scales have been used to assess postural stability and the risk of falling in patients with idiopathic Parkinson's disease ( IPD ). Quantitative posturography allows a more objective assessment but the findings in previous studies have been inconsistent and few studies have investigated which posturographic measures correlate best with a history of falling. The purpose of this study was to determine the efficacy of clinical tests, balance scales, and stable-platform posturography in detecting postural instability and discriminating between fallers and non-fallers in a home-dwelling PD cohort. Forty-eight PD subjects ( Hoehn & Yahr stage 1–3 ) and 17 age-matched controls had the following assessments: Activities-specific Balance Confidence scale, Berg Balance Scale, Unified Parkinson's Disease Rating Scale ( UPDRS ) ( motor ), pull-test, timed up-and-go, static posturography, and dynamic posturography to assess multidirectional leaning balance. Of the clinical assessments, all but the pull-test were closely correlated with a history of falling. Static posturography discriminated between PD fallers and controls but not between PD fallers and non-fallers, whereas dynamic posturography ( reaction time, velocity, and target hit-time ) also discriminated between fallers and non-fallers. Our findings suggest that this combination of clinical and posturographic measures would be useful in the prospective assessment of falls risk in PD patients. A further prospective study is now required to assess their predictive value.

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Journal Article

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