帕金森病与跌倒的研究进展_West China Medical Journal

Authors：

孙潇逸 , 余文娟 ,  彭蓉

四川大学华西医院神经内科（成都 610041）;

Corresponding author：

彭蓉, Email: qrongpeng@126.com

Keywords：

帕金森病; 跌倒; 发病机制; 危险因素; 评估; 预防与治疗

DOI：

10.7507/1002-0179.201504169

Video：

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帕金森病是一种常见的神经系统变性疾病，以静止性震颤、肌强直、运动迟缓及姿势步态异常为主要表现。跌倒作为晚期帕金森病患者常见且具有重要致残性的症状，严重影响了患者的生活质量，近年来越来越受到人们的关注。基于跌倒对帕金森病患者的严重影响，该文将最近几年对帕金森病伴跌倒的流行病学、危险因素、发生机制、评估、预防及治疗方面的研究进行了综述，以加深临床医生对帕金森病伴跌倒的重视，亦对临床工作作出指导。

Citation： 孙潇逸, 余文娟, 彭蓉. 帕金森病与跌倒的研究进展. West China Medical Journal, 2017, 32(4): 622-625. doi: 10.7507/1002-0179.201504169 Copy

1.	Lamb SE, Jørstad-Stein EC, Hauer K, et al. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc, 2005, 53(9): 1618-1622.
2.	Wolf SL, Barnhart HX, Kutner NG, et al. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and injuries: cooperative studies of intervention techniques. J Am Geriatr Soc, 1996, 44(5): 489-497.
3.	Voss TS, Elm JJ, Wielinski CL, et al. Fall frequency and risk assessment in early Parkinson’s disease. Parkinsonism Relat Disord, 2012, 18(7): 837-841.
4.	Weiss A, Herman T, Giladi N, et al. Objective assessment of fall risk in Parkinson’s disease using a body-fixed sensor worn for 3 days. PLoS One, 2014, 9(5): e96675.
5.	Duncan RP, Leddy AL, Cavanaugh JT, et al. Accuracy of fall prediction in Parkinson disease: six-month and 12-month prospective analyses. Parkinsons Dis, 2012, 2012: 237673.
6.	Güler S, Bir LS, Akdag B, et al. The effect of pramipexole therapy on balance disorder and fall risk in Parkinson’s disease at early stage: clinical and posturographic assessment. ISRN Neurol, 2012, 2012: 320607.
7.	StackEL, Roberts HC. Slow down and concentrate: time for a paradigm shift in fall prevention among people with Parkinson’s disease? . Parkinsons Dis, 2013, 2013: 704237.
8.	Paul SS, Sherrington C, Canning CG, et al. The relative contribution of physical and cognitive fall risk factors in People with Parkinson’s disease: a large prospective cohort study. Neurorehabil Neural Repair, 2014, 28(3): 282-290.
9.	Cole MH, Silburn PA, Wood JM, et al. Falls in Parkinson’s disease: evidence for altered stepping strategies on compliant surfaces. Parkinsonism Relat Disord, 2011, 17(8): 610-616.
10.	Chung KA, Lobb BM, Nutt JG, et al. Effects of a central cholinesterase inhibitor on reducing falls in Parkinson disease. Neurology, 2010, 75(14): 1263-1269.
11.	Deandrea S, Lucenteforte E, Bravi F, et al. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology, 2010, 21(5): 658-668.
12.	Bloem BR, Grimbergen YA, Cramer M, et al. Prospective assessment of falls in Parkinson’s disease. J Neurol, 2001, 248(11): 950-958.
13.	Latt MD, Lord SR, Morris JG, et al. Clinical and physiological assessments for elucidating falls risk in Parkinson’s disease. Mov Disord, 2009, 24(9): 1280-1289.
14.	Medow MS, Stewart JM, Sanyal S, et al. Pathophysiology, diagnosis, and treatment of orthostatic hypotension and vasovagal syncope. Cardiol Rev, 2007, 16(1): 4-20.
15.	Mak MK, Pang MY. Parkinsonian single fallers versus recurrent fallers: different fall characteristics and clinical features. J Neurol, 2010, 257(9): 1543-1551.
16.	Matinolli M, Korpelainen JT, Korpelainen R, et al. Mobility and balance in Parkinson’s disease: a population-based study. Eur J Neurol, 2009, 16(1): 105-111.
17.	Matinolli M, Korpelainen JT, Sotaniemi KA, et al. Recurrent falls and mortality in Parkinson’s disease: a prospective two-year follow-up study. Acta Neurol Scand, 2011, 123(3): 193-200.
18.	Thomas AA, Rogers JM, Amick MM, et al. Falls and the falls efficacy scale in Parkinson’s disease. J Neurol, 2010, 257(7): 1124-1128.
19.	Mahabier SW, Snijders AH, Delval A, et al. Freezing of gait//Kompoliti K, Verhagen Metman L. Encyclopedia of movement disorders. Oxford: Academic Press, 2010: 486-491.
20.	Snijders AH, Nijkrake MJ, Bakker M, et al. Clinimetrics of freezing of gait. Mov Disord, 2008, 23(Suppl 2): S468-S474.
21.	Nilsson MH, Hariz GM, Wictorin K, et al. Development and testing of a self administered version of the Freezing of Gait Questionnaire. BMC Neurol, 2010, 23(10): 85.
22.	Mak MK, Pang MY. Balance confidence and functional mobility are independently associated with falls in people with Parkinson’s disease. J Neurol, 2009, 256(5): 742-749.
23.	Schilling BK, Karlage RE, Ledoux MS, et al. Impaired leg extensor strength in individuals with Parkinson disease and relatedness to functional mobility. Parkinsonism Relat Disord, 2009, 15(10): 776-780.
24.	Rolinski M, Fox C, Maidment I, et al. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev, 2012, 14(3): CD006504.
25.	van der Marck MA, Klok MP, Okun MS, et al. Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson’s disease. Parkinsonism Relat Disord, 2014, 20(4): 360-369.
26.	Kerr GK, Worringham CJ, Cole MH, et al. Predictors of future falls in Parkinson disease. Neurology, 2010, 75(2): 116-124.
27.	Mirelman A, Heman T, Yasinovsky K, et al. Fall risk and gait in Parkinson’s disease: the role of theLRRK2 G2019S mutation. Mov Disord, 2013, 28(12): 1683-1690.
28.	Goetz CG, Fahn S, Martinez-Martin P, et al. Movement disorder society-sponsored revision of the unified Parkinson’s disease rating scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord, 2007, 22(1): 41-47.
29.	Kucinski A, Paolone G, Bradshaw M, et al. Modeling fall propensity in Parkinson’s disease: deficits in the attentional control of complex movements in rats with cortical-cholinergic and striatal-dopaminergic deafferentation. J Neurosci, 2013, 33(42): 16522-16539.
30.	Bencherif B, Endres CJ, Musachio JL, et al. PET imaging of brain acetylcholinesterase using [11C] CP-126, 998, a brain selective enzyme inhibitor. Synapse, 2002, 45(1): 1-9.
31.	Graham A, Court JA, Martin-Ruiz CM, et al. Immunohistochemical localisation of nicotinic acetylcholine receptor subunits in human cerebellum. Neuroscience, 2002, 113(3): 493-507.
32.	Karachi C, Grabli D, Bernard FA, et al. Cholinergic mesencephalic neurons are involved in gait and postural disorders in Parkinson disease. J Clin Invest, 2010, 120(8): 2745-2754.
33.	Plotnik M, Giladi N, Dagan Y, et al. Postural instability and fall risk in Parkinson’s disease: impaired dual tasking, pacing, and bilateral coordination of gait during the " ON” medication state. Exp Brain Res, 2011, 210(3/4): 529-538.
34.	Bohnen NI, Albin RL. Cholinergic denervation occurs early in Parkinson disease. Neurology, 2009, 73(4): 256-257.
35.	Nieuwboer A, Rochester L, Herman T, et al. Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson’s disease and their carers. Gait Posture, 2009, 30(4): 459-463.
36.	Powell LE, Myers AM. The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci, 1995, 50A(1): M28-M34.
37.	Horak FB, Wrisley DM, Frank J. The balance evaluation systems test (BESTest)to differentiate balance deficits. Phys Ther, 2009, 89(5): 484-498.
38.	Leddy AL, Crowner BE, Earhart GM. Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Phys Ther, 2011, 91(1): 102-113.
39.	Ellis T, Cavanaugh JT, Earhart GM, et al. Which measures of physical function and motor impairment best predict quality of life in Parkinson’s disease? Parkinsonism Relat Disord, 2011, 17(9): 693-697.
40.	Tomlinson CL, Patel S, Meek C, et al. Physiotherapyversus placebo or no intervention in Parkinson’s disease. Cochrane Database Syst Rev, 2012, 15(8): CD002817.
41.	Gao Q, Leung A, Yang Y, et al. Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial. Clin Rehabil, 2014, 28(8): 748-753.
42.	Cheng KY, Lin WC, Chang WN, et al. Factors associated with fall-related fractures in Parkinson’s disease. Parkinsonism Relat Disord, 2014, 20(1): 88-92.

1. Lamb SE, Jørstad-Stein EC, Hauer K, et al. Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc, 2005, 53(9): 1618-1622.
2. Wolf SL, Barnhart HX, Kutner NG, et al. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. Atlanta FICSIT Group. Frailty and injuries: cooperative studies of intervention techniques. J Am Geriatr Soc, 1996, 44(5): 489-497.
3. Voss TS, Elm JJ, Wielinski CL, et al. Fall frequency and risk assessment in early Parkinson’s disease. Parkinsonism Relat Disord, 2012, 18(7): 837-841.
4. Weiss A, Herman T, Giladi N, et al. Objective assessment of fall risk in Parkinson’s disease using a body-fixed sensor worn for 3 days. PLoS One, 2014, 9(5): e96675.
5. Duncan RP, Leddy AL, Cavanaugh JT, et al. Accuracy of fall prediction in Parkinson disease: six-month and 12-month prospective analyses. Parkinsons Dis, 2012, 2012: 237673.
6. Güler S, Bir LS, Akdag B, et al. The effect of pramipexole therapy on balance disorder and fall risk in Parkinson’s disease at early stage: clinical and posturographic assessment. ISRN Neurol, 2012, 2012: 320607.
7. StackEL, Roberts HC. Slow down and concentrate: time for a paradigm shift in fall prevention among people with Parkinson’s disease? . Parkinsons Dis, 2013, 2013: 704237.
8. Paul SS, Sherrington C, Canning CG, et al. The relative contribution of physical and cognitive fall risk factors in People with Parkinson’s disease: a large prospective cohort study. Neurorehabil Neural Repair, 2014, 28(3): 282-290.
9. Cole MH, Silburn PA, Wood JM, et al. Falls in Parkinson’s disease: evidence for altered stepping strategies on compliant surfaces. Parkinsonism Relat Disord, 2011, 17(8): 610-616.
10. Chung KA, Lobb BM, Nutt JG, et al. Effects of a central cholinesterase inhibitor on reducing falls in Parkinson disease. Neurology, 2010, 75(14): 1263-1269.
11. Deandrea S, Lucenteforte E, Bravi F, et al. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology, 2010, 21(5): 658-668.
12. Bloem BR, Grimbergen YA, Cramer M, et al. Prospective assessment of falls in Parkinson’s disease. J Neurol, 2001, 248(11): 950-958.
13. Latt MD, Lord SR, Morris JG, et al. Clinical and physiological assessments for elucidating falls risk in Parkinson’s disease. Mov Disord, 2009, 24(9): 1280-1289.
14. Medow MS, Stewart JM, Sanyal S, et al. Pathophysiology, diagnosis, and treatment of orthostatic hypotension and vasovagal syncope. Cardiol Rev, 2007, 16(1): 4-20.
15. Mak MK, Pang MY. Parkinsonian single fallers versus recurrent fallers: different fall characteristics and clinical features. J Neurol, 2010, 257(9): 1543-1551.
16. Matinolli M, Korpelainen JT, Korpelainen R, et al. Mobility and balance in Parkinson’s disease: a population-based study. Eur J Neurol, 2009, 16(1): 105-111.
17. Matinolli M, Korpelainen JT, Sotaniemi KA, et al. Recurrent falls and mortality in Parkinson’s disease: a prospective two-year follow-up study. Acta Neurol Scand, 2011, 123(3): 193-200.
18. Thomas AA, Rogers JM, Amick MM, et al. Falls and the falls efficacy scale in Parkinson’s disease. J Neurol, 2010, 257(7): 1124-1128.
19. Mahabier SW, Snijders AH, Delval A, et al. Freezing of gait//Kompoliti K, Verhagen Metman L. Encyclopedia of movement disorders. Oxford: Academic Press, 2010: 486-491.
20. Snijders AH, Nijkrake MJ, Bakker M, et al. Clinimetrics of freezing of gait. Mov Disord, 2008, 23(Suppl 2): S468-S474.
21. Nilsson MH, Hariz GM, Wictorin K, et al. Development and testing of a self administered version of the Freezing of Gait Questionnaire. BMC Neurol, 2010, 23(10): 85.
22. Mak MK, Pang MY. Balance confidence and functional mobility are independently associated with falls in people with Parkinson’s disease. J Neurol, 2009, 256(5): 742-749.
23. Schilling BK, Karlage RE, Ledoux MS, et al. Impaired leg extensor strength in individuals with Parkinson disease and relatedness to functional mobility. Parkinsonism Relat Disord, 2009, 15(10): 776-780.
24. Rolinski M, Fox C, Maidment I, et al. Cholinesterase inhibitors for dementia with Lewy bodies, Parkinson’s disease dementia and cognitive impairment in Parkinson’s disease. Cochrane Database Syst Rev, 2012, 14(3): CD006504.
25. van der Marck MA, Klok MP, Okun MS, et al. Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson’s disease. Parkinsonism Relat Disord, 2014, 20(4): 360-369.
26. Kerr GK, Worringham CJ, Cole MH, et al. Predictors of future falls in Parkinson disease. Neurology, 2010, 75(2): 116-124.
27. Mirelman A, Heman T, Yasinovsky K, et al. Fall risk and gait in Parkinson’s disease: the role of theLRRK2 G2019S mutation. Mov Disord, 2013, 28(12): 1683-1690.
28. Goetz CG, Fahn S, Martinez-Martin P, et al. Movement disorder society-sponsored revision of the unified Parkinson’s disease rating scale (MDS-UPDRS): process, format, and clinimetric testing plan. Mov Disord, 2007, 22(1): 41-47.
29. Kucinski A, Paolone G, Bradshaw M, et al. Modeling fall propensity in Parkinson’s disease: deficits in the attentional control of complex movements in rats with cortical-cholinergic and striatal-dopaminergic deafferentation. J Neurosci, 2013, 33(42): 16522-16539.
30. Bencherif B, Endres CJ, Musachio JL, et al. PET imaging of brain acetylcholinesterase using [11C] CP-126, 998, a brain selective enzyme inhibitor. Synapse, 2002, 45(1): 1-9.
31. Graham A, Court JA, Martin-Ruiz CM, et al. Immunohistochemical localisation of nicotinic acetylcholine receptor subunits in human cerebellum. Neuroscience, 2002, 113(3): 493-507.
32. Karachi C, Grabli D, Bernard FA, et al. Cholinergic mesencephalic neurons are involved in gait and postural disorders in Parkinson disease. J Clin Invest, 2010, 120(8): 2745-2754.
33. Plotnik M, Giladi N, Dagan Y, et al. Postural instability and fall risk in Parkinson’s disease: impaired dual tasking, pacing, and bilateral coordination of gait during the " ON” medication state. Exp Brain Res, 2011, 210(3/4): 529-538.
34. Bohnen NI, Albin RL. Cholinergic denervation occurs early in Parkinson disease. Neurology, 2009, 73(4): 256-257.
35. Nieuwboer A, Rochester L, Herman T, et al. Reliability of the new freezing of gait questionnaire: agreement between patients with Parkinson’s disease and their carers. Gait Posture, 2009, 30(4): 459-463.
36. Powell LE, Myers AM. The activities-specific balance confidence (ABC) scale. J Gerontol A Biol Sci Med Sci, 1995, 50A(1): M28-M34.
37. Horak FB, Wrisley DM, Frank J. The balance evaluation systems test (BESTest)to differentiate balance deficits. Phys Ther, 2009, 89(5): 484-498.
38. Leddy AL, Crowner BE, Earhart GM. Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall. Phys Ther, 2011, 91(1): 102-113.
39. Ellis T, Cavanaugh JT, Earhart GM, et al. Which measures of physical function and motor impairment best predict quality of life in Parkinson’s disease? Parkinsonism Relat Disord, 2011, 17(9): 693-697.
40. Tomlinson CL, Patel S, Meek C, et al. Physiotherapyversus placebo or no intervention in Parkinson’s disease. Cochrane Database Syst Rev, 2012, 15(8): CD002817.
41. Gao Q, Leung A, Yang Y, et al. Effects of Tai Chi on balance and fall prevention in Parkinson’s disease: a randomized controlled trial. Clin Rehabil, 2014, 28(8): 748-753.
42. Cheng KY, Lin WC, Chang WN, et al. Factors associated with fall-related fractures in Parkinson’s disease. Parkinsonism Relat Disord, 2014, 20(1): 88-92.

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