Influence of fear of falling on gait and balance in Parkinson’s disease

PURPOSE: To study the relationship of fear of falling (FoF) with gait characteristics and balance in individuals with Parkinson's disease (PD). METHOD: Seventy-nine non-demented individuals (62 males) with PD were studied. Their mean age was 69.22 ± 8.93 years. The average time since diagnosis was 8.27 ± 5.31 years. FoF was assessed by the Activities-specific Balance Confidence (ABC) Scale in which high scores indicate less FoF. Gait was measured using a computerized walkway. Balance was measured by timed tests including the 5-step test, 360 degree turn, timed sideways walk, and timed up and go test. Participants were divided into two groups based on their ABC score (high FoF, ABC score <69; low FoF, ABC score ≥69). Gait characteristics and balance measures of the two groups were compared. RESULTS: Gait speed and stride length for forward walking (p < 0.0005 for both) and backward walking (p = 0.001 and 0.002, respectively) were lower for those with a high level of FoF compared to those with a low level of FoF. The time to take five steps (p = 0.025), time to turn (p < 0.0005), time to walk sideways (p = 0.001), and time to complete the up and go test (p = 0.003) were longer in those with a high level of FoF than in those with a low level of FoF. Number of steps to complete the turn (p = 0.001) and steps to walk sideways (p = 0.002) were greater in those with a high level of FoF than in those with a low level FoF. CONCLUSIONS: Gait and balance of individuals with PD with a high level of FoF were poorer than those with a low level of FoF, regardless of previous fall history. Implications for Rehabilitation The results demonstrates that fear of falling (FoF) is related to gait and balance in individuals with PD. Clinicians should be aware that FoF has a negative impact on gait and balance in individuals with PD.