1. Epidemiology and pathophysiology of falls in facioscapulohumeral disease
- Author
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B.G.M. van Engelen, George W. Padberg, A. Bickerstaffe, Corinne G.C. Horlings, Marten Munneke, L. Laverman, Bastiaan R. Bloem, John H. J. Allum, and Rehabilitation medicine
- Subjects
Male ,medicine.medical_specialty ,Neuromuscular disease ,Quality of nursing and allied health care [NCEBP 6] ,Poison control ,Physical medicine and rehabilitation ,Surveys and Questionnaires ,Injury prevention ,Prevalence ,Perception and Action [DCN 1] ,medicine ,Humans ,Muscle Strength ,Prospective Studies ,Risk factor ,Postural Balance ,Netherlands ,Retrospective Studies ,Balance (ability) ,Muscle Weakness ,business.industry ,Lower limb muscle weakness ,Muscle weakness ,Middle Aged ,medicine.disease ,Muscular Dystrophy, Facioscapulohumeral ,Psychiatry and Mental health ,Accidents, Home ,Physical therapy ,Accidental Falls ,Female ,Surgery ,Neurology (clinical) ,medicine.symptom ,business ,Fall prevention - Abstract
Contains fulltext : 80775.pdf (Publisher’s version ) (Closed access) BACKGROUND AND AIMS: Muscle weakness is a potentially important, yet poorly studied, risk factor for falls. Detailed studies of patients with specific myopathies may shed new light on the relation between muscle weakness and falls. Here falls in patients with facioscapulohumeral disease (FSHD) who suffered from lower limb muscle weakness were examined. This study provides insights into the prevalence, relevance and pathophysiology of falls in FSHD. METHODS: A validated questionnaire was used as well as a prospective 3 month follow-up to examine the prevalence, circumstances and consequences of falls in 73 patients with FSHD and 49 matched healthy controls. In a subgroup of 28 subjects, muscle strength was also examined and balance was assessed electrophysiologically using body worn gyroscopes. RESULTS: In the questionnaire, 30% of the patients reported falling at least once a month whereas none of the controls did. Injuries occurred in almost 70% of the patients. The prospective study showed that patients fell mostly at home, mainly due to intrinsic (patient related) causes, and usually in a forward direction. Fallers were unstable while climbing stairs, rising from a chair and standing with eyes closed whereas non-fallers had normal balance control. Frequent fallers had greater muscle weakness than infrequent fallers. CONCLUSION: These findings demonstrate the high prevalence and clinical relevance of falls in FSHD. The relation between muscle weakness and instability among fallers is also highlighted. Because patients fell mainly at home, fall prevention strategies should focus on home adaptations. As mainly intrinsic causes underlie falls, the impact of adopting balance strategies or balance training should be explored in this patient group.
- Published
- 2009