Fear of falling and falls in people with Parkinson's disease treated with deep brain stimulation in the subthalamic nuclei.

BACKGROUND

No previous study prospectively investigated the effects of subthalamic deep brain stimulation on fear of falling (FOF) and falls.

AIM: The aim was to prospectively explore whether FOF and fall rate were affected after STN stimulation in people with Parkinson's disease (PD).

METHODS

Twenty participants (mean age: 65, SD 6.4) were included. Falls and near falls were recorded (fall diary) during 3 months before and 1 year after surgery. FOF was evaluated using the Falls-Efficacy Scale, Swedish version, FES(S), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE).

RESULTS

After surgery, the FES(S) scores of complex activities improved (P=0.026), i.e. median 34 (q1-q3, 26-50) vs 43 (32-55). SAFFE scores also improved (P=0.007): median 25 (22-30) versus 22 (18-27). The rate of near falls decreased (P=0.014). Nine participants reported no near falls. For the remaining ten participants, the median near fall rate decreased from 6 (3-17) to 2 (1-8). The rate of falls showed no significant (P>0.3) difference.

CONCLUSIONS

After surgery, fewer activities were avoided owing to the risk of falling, and fall-related self-efficacy had improved during complex activities. The rate of near falls decreased. The results cannot support any change in fall rate.