Factors associated with falling in patients with Parkinson's disease and atypical parkinsonism: An assessment using the Tinetti Gait and Balance Scale

Aim: To identify factors associated with falling, we assessed the Tinetti Gait and Balance Scale (TGBS) for patients with Parkinson’s disease (PD) and atypical parkinsonism (AP), and assessed the Unified Parkinson’s Disease Rating Scale (UPDRS) for patients with PD. Methods: A cross sectional study was conducted in a university hospital, with the subject constituting 30 PD patients and 22 AP patients. Each item included in the TGBS and the UPDRS part III were scored in the clinical setting. Fallers were categorized if the patient experienced at least one fall in the prior six-month period. Results: Thirty-five patients were categorized as fallers. When comparing PD fallers and PD non-fallers, a subscore comprising a sum with ‘walk stance’ and ‘nudge on sternum’ in the TGBS showed a significant difference. Total UPDRS part III score indicated a significant difference during the medication ON period, whereas the difference was insignificant during the medication OFF period. The presence of dyskinesia or freezing of gait was not different. In addition, ‘walk stance’ only in the TGBS showed a significant difference between PD fallers and AP fallers. Conclusions: We concluded that ‘walk stance’ and ‘nudge on sternum’ in the TGBS may be useful for evaluating factors associated to falling in PD. ‘Walk stance’ item merits inclusion into routine assessment in PD in addition to UPDRS part III.