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Parkinson’s Disease
Volume 2012 (2012), Article ID 923493, 6 pages
Clinical Study

Should One Measure Balance or Gait to Best Predict Falls among People with Parkinson Disease?

1Program in Physical Therapy, Washington University in St. Louis School of Medicine, Campus Box 8502, 4444 Forest Park Boulevard, St. Louis, MO 63108, USA
2Department of Anatomy & Neurobiology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA
3Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA

Received 2 August 2012; Revised 14 September 2012; Accepted 4 October 2012

Academic Editor: Ann Ashburn

Copyright © 2012 Ryan P. Duncan and Gammon M. Earhart. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Introduction. We aimed to determine whether gait velocity is as useful as a balance test, a self-report measure of freezing of gait (FOG), and/or a measure of motor symptom severity for predicting falls among people with Parkinson Disease (PD). Methods. Fifty-six individuals with idiopathic PD completed a baseline assessment consisting of these measures: (1) MDS-UPDRS III, (2) Mini-BESTest, (3) gait velocity (forward, backward, dual task, and fast), and (4) FOGQ. Retrospective fall history was collected at baseline and six months later. Participants were considered fallers if they had two or more falls in the surveillance period. Ability of the tests to discriminate between fallers and nonfallers was determined using ROC curves followed by pairwise statistical noninferiority comparisons ( ) of the area under the ROC curve (AUC) for each test. Results. At six months, 22% ( ) of the sample were fallers. Fallers differed significantly from nonfallers on the MDS-UPDRS III, Mini-BESTest, backward gait velocity, and FOGQ. The Mini-BESTest had the highest AUC and was superior to all gait velocity measures at identifying fallers. Conclusion. A single measure of gait velocity, even in a challenging condition, may not be as effective as the Mini-BESTest in identifying fallers among people with PD.