Incidence and prediction of falls in Parkinson's disease: a prospective multidisciplinary study Clinical and posturographic correlates of falling in Parkinson's disease. Diagnosis of Fall Risk in Parkinson Disease: An Analysis of Individual and Collective Clinical Balance Test Interpretation External validation of a simple clinical tool used to predict falls in people with Parkinson disease. Validity of the Functional Gait Assessment in Patients With Parkinson Disease: Construct, Concurrent, and Predictive Validity Effect of Balance Training on Postural Instability in Patients With Idiopathic Parkinson’s Disease Three simple clinical tests to accurately predict falls in people with Parkinson's disease. Predicting Fallers in a Community-Based Sample of People with Parkinson’s Disease Objective Assessment of Fall Risk in Parkinson's Disease Using a Body-Fixed Sensor Worn for 3 Days Comparison of Self-report and Performance-Based Balance Measures for Predicting Recurrent Falls in People With Parkinson Disease: Cohort Study A novel conceptual framework for balance training in Parkinson’s disease-study protocol for a randomised controlled trial Toward Automated, At-Home Assessment of Mobility Among Patients With Parkinson Disease, Using a Body-Worn Accelerometer Measuring the impact of Parkinson's disease with the Parkinson's Disease Quality of Life questionnaire. A randomised controlled trial of a home based exercise programme to reduce the risk of falling among people with Parkinson’s disease Accuracy of Fall Prediction in Parkinson Disease: Six-Month and 12-Month Prospective Analyses Balance and Gait Training With Augmented Feedback Improves Balance Confidence in People With Parkinson’s Disease Validating the Berg Balance Scale for patients with Parkinson's disease: a key to rehabilitation evaluation.
Objectives : To accurately establish the incidence of falls in Parkinson 's disease ( PD ) and to investigate predictive risk factors for fallers from baseline data . Methods : 109 subjects with idiopathic PD diagnosed according to the brain bank criteria underwent a multidisciplinary baseline assessment comprising demographic and historical data , disease specific rating scales , physiotherapy assessment , tests of visual , cardiovascular and autonomic function , and bone densitometry . Patients were then prospect ively followed up for one year using weekly prepaid postcards along with telephone follow up . Results : Falls occurred in 68.3 % of the subjects . Previous falls , disease duration , dementia , and loss of arm swing were independent predictors of falling . There were also significant associations between disease severity , balance impairment , depression , and falling . Conclusions : Falls are a common problem in PD and some of the major risk factors are potentially modifiable . There is a need for future studies to look at interventions to prevent falls in PD Various clinical tests and balance scales have been used to assess postural stability and the risk of falling in patients with idiopathic Parkinson 's disease ( IPD ) .  Quantitative posturography allows a more objective assessment but the findings in previous studies have been inconsistent and few studies have investigated which posturographic measures correlate best with a history of falling . The purpose of this study was to determine the efficacy of clinical tests , balance scales , and  stable-platform posturography  in detecting postural instability and discriminating between fallers and non-fallers in a home-dwelling PD cohort . Forty-eight PD subjects ( Hoehn & Yahr stage 1 - 3 ) and 17 age-matched controls had the following assessment s : Activities-specific Balance Confidence scale , Berg Balance Scale , Unified Parkinson 's Disease Rating Scale ( UPDRS ) ( motor ) , pull-test , timed up- and -go , static posturography , and dynamic posturography to assess multidirectional leaning balance . Of the clinical assessment s , all but the pull-test were closely correlated with a history of falling .  Static posturography  discriminated between PD fallers and controls but not between PD fallers and non-fallers , whereas  dynamic posturography ( reaction time , velocity , and target hit-time ) also discriminated between fallers and non-fallers . Our findings suggest that this combination of clinical and posturographic measures would be useful in the prospect i ve assessment of falls risk in PD patients . A further prospect i ve study is now required to assess their predictive value . © 2013 Movement Disorder Society Background and Purpose : Parkinson disease ( PD ) results in an increased frequency of falls relative to the frequency in neurologically healthy people . The purpose of this study was to compare the accuracy of PD fall risk diagnosis based on one test with that based on the collective interpretation of multiple tests . Participants : Seventy people with PD ( mean age=73.91 years ) participated in this study . Method : Clinical balance tests were conducted during the initial examinations of people with PD .  Validity indices were calculated for individual tests and compared with validity indices calculated for a combination of multiple tests . Results : Thirty-six participants reported a fall history . Analysis of individual tests revealed broad variations in validity indices , whereas the collective interpretation of multiple tests improved sensitivity and negative likelihood ratios . Discussion and Conclusion : Collective interpretation of clinical balance tests result ed in fewer false-negative results and more substantial adjustments to the posttest probability of being a “ faller ” than the interpretation of one test alone . These results should be confirmed in a prospect i ve examination of fall risk in PD BACKGROUND Assessment of fall risk in an individual with Parkinson disease ( PD ) is a critical yet often time consuming component of patient care . Recently a simple clinical prediction tool based only on fall history in the previous year , freezing of gait in the past month , and gait velocity < 1.1 m/s was developed and accurately predicted future falls in a sample of individuals with PD . METHODS We sought to externally vali date the utility of the tool by administering it to a different cohort of 171 individuals with PD .  Falls were monitored prospect ively for 6 months following predictor assessment . RESULTS The tool accurately discriminated future fallers from non-fallers ( area under the curve [ AUC ] = 0.83 ; 95 % CI 0.76 - 0.89 ) , comparable to the developmental study . CONCLUSION The results vali date d the utility of the tool for allowing clinicians to quickly and accurately identify an individual 's risk of an impending fall Background The Functional Gait Assessment ( FGA ) is a vali date d measurement of gait-related activities in certain population s and may be potentially useful to assess balance and gait disorders in patients with Parkinson disease ( PD ) . Objective The purpose of this study was to determine the construct , concurrent , and predictive validity of the FGA in in patients with PD . Design This was a prospect i ve cohort study . Methods One hundred twenty-one in patients with PD were prospect ively enrolled . The FGA and other relevant appraisal s of gait , balance , disease severity , and activities of daily living were performed . Six months later , the patients were interviewed by telephone to have their fall information collected . Principal component analysis was used to determine construct validity . Spearman correlation coefficients were used to determine concurrent validity between the FGA and other measures . Cutoff point , sensitivity , specificity , and positive likelihood ratio were calculated for predictive validity based on the receiver operating characteristic curve . Results One common factor was extracted for construct validity , which cumulatively explained 64.0 % of the total variance . Correlation coefficients for the FGA compared with other measures ranged from .57 to .85 . The cutoff point for predicting falls was 18 , with sensitivity of 80.6 % , specificity of 80.0 % , and positive likelihood ratio of 4.03 . Limitations This study was limited by the length of time of follow-up and self-reports of falls without the requirement of a fall diary . Medication adjustment after the FGA evaluation may have led to a different cutoff score for identifying those patients who were at risk of falling . Conclusions The FGA demonstrated good construct validity in patients with PD . It had moderate to strong correlations with other balance and gait appraisal s. The FGA can be used to predict falls within the subsequent 6 months Background . Postural instability ( PI ) is a disabling sign of Parkinson ’s disease ( PD ) not easily amenable to treatment with medication . Objective . To evaluate the effects of balance training on PI in patients with PD . Methods . A total of 64 patients with PI were r and omly assigned to the experimental group ( n = 33 ) for balance training or to the control group ( n = 31 ) for general physical exercises . Each patient received 21 treatment sessions of 50 minutes each . Patients were evaluated by a blinded rater before and after treatment as well as 1 month posttreatment using the Berg Balance Scale ( BBS ) , Activities-Specific Balance Confidence Scale ( ABC ) , postural transfer test , self-destabilization of the center of foot pressure test , number of falls , Unified Parkinson ’s Disease Rating Scale ( UPDRS ) , modified Hoehn and Yahr ( H&Y ) Staging Scale , and Geriatric Depression Scale ( GDS ) . Results .At the end of treatment , the experimental group showed significant improvements in all outcome measures , except for the UPDRS and the H&Y scale . Improvement was maintained at the 1-month follow-up in all outcome measures except for the GDS . No significant changes in performance were observed in the control group . Conclusions . A program of balance training can improve PI in patients with PD Falls are a major cause of morbidity in Parkinson 's disease ( PD ) . The objective of this study was to identify predictors of falls in PD and develop a simple prediction tool that would be useful in routine patient care . Potential predictor variables ( falls history , disease severity , cognition , leg muscle strength , balance , mobility , freezing of gait [ FOG ] , and fear of falling ) were collected for 205 community-dwelling people with PD .  Falls were monitored prospect ively for 6 months using monthly falls diaries . In total , 125 participants ( 59 % ) fell during follow-up . A model that included a history of falls , FOG , impaired postural sway , gait speed , sit-to-st and , st and ing balance with narrow base of support , and coordinated stability had high discrimination in identifying fallers ( area under the receiver-operating characteristic curve [ AUC ] , 0.83 ; 95 % confidence interval [ CI ] , 0.77 - 0.88 ) . A clinical tool that incorporated 3 predictors easily determined in a clinical setting ( falling in the previous year : odds ratio [ OR ] , 5.80 ; 95 % CI , 3.00 - 11.22 ; FOG in the past month : OR , 2.39 ; 95 % CI , 1.19 - 4.80 ; and self-selected gait speed < 1.1 meters per second : OR , 1.86 ; 95 % CI , 0.96 - 3.58 ) had similar discrimination ( AUC , 0.80 ; 95 % CI , 0.73 - 0.86 ) to the more complex model ( P = 0.14 for comparison of AUCs ) . The absolute probability of falling in the next 6 months for people with low , medium , and high risk using the simple , 3-test tool was 17 % , 51 % , and 85 % , respectively . In people who have PD without significant cognitive impairment , falls can be predicted with a high degree of accuracy using a simple , 3-test clinical tool . This tool enables individualized quantification of the risk of falling . © 2013 Movement Disorder Society Background : The risk of people with Parkinson ’s disease ( PD ) falling is greater than that of the general population but to date , disease-specific predictors of falling have not been identified . Objectives : To identify one or more features , which would predict individuals at risk of falling during a 3-month prospect i ve follow-up study . Method : A battery of st and ardised tests administered in the home and the laboratory with a 3-month follow-up telephone interview . Results : Sixty-three people with PD were recruited from GP practice s. Eleven interview variables and six gait laboratory variables were used with sub sample s ( 55 and 44 subjects , respectively ) to fit predictive models for identifying future fallers . The number of falls in the previous year was the most important variable , without exception , to be selected as a predictor in various logistic regression models . A history of two or more falls had a sensitivity of 86.4 % ( 95 % CI 67.3–96.2 % ) and a specificity of 85.7 % ( 95 % CI 71.2–94.2 % ) in predicting falling in the next 3 months . Conclusion : Healthcare workers should be asking their patients with PD regularly and carefully about falling , and should consider instigating programmes of fall management for patients with PD who have fallen two or more times in the previous 12 months Background Patients with Parkinson 's disease ( PD ) suffer from a high fall risk . Previous approaches for evaluating fall risk are based on self-report or testing at a given time point and may , therefore , be insufficient to optimally capture fall risk . We tested , for the first time , whether metrics derived from 3 day continuous recordings are associated with fall risk in PD . Methods and Material s 107 patients ( Hoehn & Yahr Stage : 2.6±0.7 ) wore a small , body-fixed sensor ( 3D accelerometer ) on lower back for 3 days .  Walking quantity ( e.g. , steps per 3-days ) and quality ( e.g. , frequency-derived measures of gait variability ) were determined . Subjects were classified as fallers or non-fallers based on fall history . Subjects were also followed for one year to evaluate predictors of the transition from non-faller to faller . Results The 3 day acceleration derived measures were significantly different in fallers and non-fallers and were significantly correlated with previously vali date d measures of fall risk . Walking quantity was similar in the two groups . In contrast , the fallers walked with higher step-to-step variability , e.g. , anterior-posterior width of the dominant frequency was larger ( p = 0.012 ) in the fallers ( 0.78±0.17 Hz ) compared to the non-fallers ( 0.71±0.07 Hz ) . Among subjects who reported no falls in the year prior to testing , sensor-derived measures predicted the time to first fall ( p = 0.0034 ) , whereas many traditional measures did not . Cox regression analysis showed that anterior-posterior width was significantly ( p = 0.0039 ) associated with time to fall during the follow-up period , even after adjusting for traditional measures . Conclusions / Significance These findings indicate that a body-fixed sensor worn continuously can evaluate fall risk in PD . This sensor-based approach was able to identify transition from non-faller to faller , whereas many traditional metrics were not successful . This approach may facilitate earlier detection of fall risk and may in the future , help reduce high costs associated with falls Background Balance confidence and fear of falling are factors associated with recurrent falls in people with Parkinson disease ( PD ) . However , the accuracy for predicting falls on the basis of self-report measures has not been widely investigated . Objective The study objectives were : ( 1 ) to compare the accuracy of the  Activities-specific Balance Confidence Scale ( ABC )  and the  Falls Efficacy Scale – International ( FES-I )  with that of the  Berg Balance Scale  ( BBS ) , Dynamic Gait Index  ( DGI ) , Functional Reach Test ( FRT ) , and Timed “ Up & Go ” Test ( TUG ) for predicting recurrent falls in people with PD and ( 2 ) to explore the ability of combinations of up to 3 tests to predict recurrent falls . Design This was a prospect i ve cohort study involving 225 people with PD . Methods Participants were assessed with the  ABC , FES-I , BBS , FRT , TUG , and DGI . Participants who reported 2 or more falls in the 12-month follow-up period were classified as recurrent fallers . Areas under the receiver operating characteristic curves were determined , and the Akaike information criterion was used to select the best predictive model . Results Eighty-four participants ( 37.3 % ) were classified as recurrent fallers . Areas under the receiver operating characteristic curves for the ABC , FES-I , TUG , FRT , DGI , and BBS were 0.73 , 0.74 , 0.72 , 0.74 , 0.76 , and 0.79 , respectively . Two-test models provided additional discriminating ability compared with individual measures and had Akaike information criterion values similar to those of 3-test models , particularly the combination of the BBS with the FES-I. Limitations The lack of an external validation sample was a limitation of this study . Conclusions The ABC and FES-I demonstrated moderate accuracy in predicting recurrent falls and a predictive ability similar to that of performance-based balance measures , especially the FRT and the TUG . Two-test models showed performance similar to that of 3-test models , suggesting that a combination of 2 measures may improve the ability to predict recurrent falls in people with PD . Specifically , the combination of the BBS with the FES-I may be considered Background There is increasing scientific knowledge about the interaction between physiological ( musculoskeletal , neuromuscular , cognitive and sensory ) systems and their influence on balance and walking impairments in Parkinson ’s disease . We have developed a new conceptual framework for balance training , emphasising specific components of balance control related to Parkinson ’s disease symptoms by using highly challenging , progressive and varying training conditions . The primary aim of this proposed r and omised controlled trial will be to investigate the short-term and long-term effects of a 10-week balance training regime in elderly with Parkinson ’s disease . Methods / Design Eighty participants with mild to moderate idiopathic Parkinson ’s disease will be recruited and r and omly allocated to an intervention group receiving balance training or a control group whose participants will continue to receive their usual care . The intervention will consist of a 10-week group training regime ( 1-hour training , three times per week ) , which will be led by two physiotherapists to ensure training progression and safety . The conceptual framework will be applied by addressing specific balance components ( sensory integration , anticipatory postural adjustments , motor agility , stability limits ) through varying training conditions and structured progression . Assessment will be conducted through a multi-dimensional battery of outcomes , prior to and immediately after the 10-week intervention , and at 9 and 15 months ’ follow-up after entering the study . Primary outcome measures will be balance performance ( assessed using the Mini Balance Evaluation Systems Test ) , change in gait velocity ( m/s ) between single and dual task walking , and fear of falling ( evaluated using the Fall Efficacy Scale International ) . Discussion This study has the potential to provide new insight and knowledge of the effects of specific , varied and challenging balance training on a wide health spectrum in elderly with PD . If found to be effective , this pragmatic approach with translation of theory into practice , can be implemented in existing outpatient care . Trial registration Objective . To develop an automated and objective method to assess mobility in Parkinson disease ( PD ) patients in daily-life setting s and to investigate whether accelerometer-derived measures discriminate between PD and healthy controls as they walk and simulate activities of daily living ( ADL ) . Methods . Healthy older adults ( 17 ) and patients with PD ( 22 ) wore a triaxial accelerometer on their lower back during short walks ( validation study ) and during a walk around the medical center to simulate daily activities ( ADL simulation ) . The variability ( consistency and rhythmicity ) of stepping was assessed . The patients completed the walks before and after taking their anti-Parkinsonian medications .  Frequency-based acceleration measures included dominant frequency , amplitude ( strength of signal frequency ) , width ( frequency dispersion ) , and slope ( a combination reflecting amplitude and width ) of the main frequency of the power spectral density in the 0.5- to 3.0-Hz b and . A subset of the Unified Parkinson-Disease Rating Scale provided a clinical measure of gait impairment ( UPDRS-Gait5 ) . A PD patient and control wore the sensors for 3 days at home . Results . The width was larger , and the amplitude and slope were smaller in the PD patients compared to the controls in the validation study and ADL simulation ( P < .02 ) . The width decreased , and the amplitude and slope increased when patients took anti-Parkinsonian medications ( P < .007 ) . Significant correlations were observed between acceleration-derived measures and UPDRS-Gait5 . The data obtained at home was similar to the clinic data . Conclusions . Frequency-derived measures are valid and sensitive estimates of stride-to-stride variability that can be used to assess the quality and consistency of walking in patients with PD in real-life setting OBJECTIVES To assess the validity of the Parkinson 's Disease Quality of  Life  ( PDQL ) question naire , a patient-specific multi-dimensional quality of life measure , in a community-based sample of patients with Parkinson 's disease ( PI ) ) using st and ardized measures of disease severity , depressive symptomatology and cognitive function . DESIGN A group of 194 patients with probable PD were r and omly selected from a community-based register and were invited to self-complete the 37-item PDQL .  Disease severity was measured by the disease-specific Webster scale , cognition by the  CAMCOG neuropsychological test  and depressive symptomatology by the self-report 15-item GDS-15 geriatric depression scale . RESULTS A total of 136 patients returned completed PDQL question naires . Significant differences ( P < 0.05 ) emerged between the pooled PDQL score of patients grouped on the basis of disease severity . Depressive symptoms and cognition were also associated with poorer perceived quality of life as measured by the PDQL . CONCLUSIONS The results of this study are indicative of the validity of the PDQL as an important additional measurement which reflects the impact of PD from the patient perspective . It shows poorer quality of life to be associated with increasing age , disease severity more severe depressive symptomatology and impaired cognitive functioning . However , the responsiveness of this instrument in the evaluation of care in PD remains to be determined Objective : To evaluate the effectiveness of a personalised home programme of exercises and strategies for repeat fallers with Parkinson ’s disease ( PD ) . Method : Patients with a confirmed diagnosis of idiopathic PD , independently mobile , living at home in the community , experiencing more than one fall in the previous 12 months and with intact gross cognitive function were invited to participate in this r and omised controlled trial . Usual care was compared with a personalised 6 week , home based exercise and strategy programme . The primary outcomes were rates of falling at 8 weeks and 6 months . Whether participants had repeat fallen , nearly fallen or experienced injurious falls were also examined . Functional Reach , the Berg Balance Test , PD Self- assessment Scale and the Euro Quol were rated by a blinded assessor . Results : Participants were r and omised to the exercise ( n = 70 ) and control ( n = 72 ) groups . There was a consistent trend towards lower fall rates in the exercise group at both 8 weeks and 6 months and lower rates of injurious falls needing medical attention at 6 months . Lower rates of repeat near falling were evident for the exercise group at 8 weeks ( p = 0.004 ) and 6 months ( p = 0.007 ) . There was a positive effect of exercises at 6 months on Functional Reach ( p = 0.009 ) and quality of life ( p = 0.033 ) . No significant differences were found on other secondary outcomes measures . Conclusion : There was a trend towards a reduction in fall events and injurious falls with a positive effect of exercises on near falls and quality of life Introduction . We analyzed the ability of four balance assessment s to predict falls in people with Parkinson Disease ( PD ) prospect ively over six and 12 months . Material s and Methods . The BESTest , Mini-BESTest , Functional Gait Assessment ( FGA ) , and Berg Balance Scale ( BBS ) were administered to 80 participants with idiopathic PD at baseline . Falls were then tracked for 12 months . Ability of each test to predict falls at six and 12 months was assessed using ROC curves and likelihood ratios ( LR ) . Results . Twenty-seven percent of the sample had fallen at six months , and 32 % of the sample had fallen at 12 months . At six months , areas under the ROC curve ( AUC ) for the tests ranged from 0.8 ( FGA ) to 0.89 ( BESTest ) with LR+ of 3.4 ( FGA ) to 5.8 ( BESTest ) . At 12 months , AUCs ranged from 0.68 ( BESTest , BBS ) to 0.77 ( Mini-BESTest ) with LR+ of 1.8 ( BESTest ) to 2.4 ( BBS , FGA ) . Discussion . The various balance tests were effective in predicting falls at six months . All tests were relatively ineffective at 12 months . Conclusion . This pilot study suggests that people with PD should be assessed biannually for fall risk Background . Fear of falling has been identified as an important and independent fall-risk predictor in patients with Parkinson ’s disease ( PD ) . However , there are inconsistent findings on the effects of balance and gait training on balance confidence . Objective . To explore whether balance and gait training with augmented feedback can enhance balance confidence in PD patients immediately after treatment and at 3- and 12-month follow-ups . Methods . A total of 51 PD patients were r and omly assigned to a balance and gait training ( BAL ) group or to an active control ( CON ) group . The BAL group received balance and gait training with augmented feedback , whereas CON participants received lower-limb strength training for 12 weeks . Outcome measures included Activities-Specific Balance Confidence ( ABC ) Scale , limits-of-stability test , single-leg-stance test , and spatiotemporal gait characteristics . All tests were administered before intervention ( Pre ) , immediately after training ( Post ) , and at 3 months ( Post3 m ) and 12 months ( Post12 m ) after treatment completion . Results . The ABC score improved marginally at Post and significantly at Post3 m and Post12 m only in the BAL group ( P < .017 ) . Both participant groups increased their end point excursion at Post , but only the BAL group maintained the improvement at Post3 m . The BAL group maintained significantly longer time-to-loss-of-balance during the single-leg stance test than the CON group at Post3 m and Post12 m ( P < .05 ) . For gait characteristics , both participant groups increased gait velocity , but only the BAL group increased stride length at Post , Post3 m , and Post12 m ( P < .017 ) . Conclusions . Positive findings from this study provide evidence that BAL with augmented feedback could enhance balance confidence and balance and gait performance in patients with PD OBJECTIVE To assess the criterion-related validity of the  Berg Balance Scale ( BBS ) in subjects with Parkinson 's disease ( PD ) . DESIGN Prospect i ve , correlational analysis between the BBS and accepted measures of PD motor and functional impairment . SETTING The federally funded PD research center , an interdisciplinary center of excellence for people with PD within a Veterans Affairs medical center . PARTICIPANTS Thirty-eight men ( average + /- st and ard deviation , 71.1+/-10.5 y ) with confirmed PD . Their initial diagnosis had been made on average 5.8+/-3.6 years earlier . All could st and or walk unassisted and had mild to moderate disability . Patients who could not ambulate without assistive devices were excluded . INTERVENTIONS Not applicable . MAIN OUTCOME MEASURES Correlational analyses between the  BBS  and the Unified Parkinson 's Disease Rating Scale ( UPDRS ) motor scale , Modified Hoehn and Yahr Staging ( Hoehn and Yahr ) Scale , and the Modified Schwab and Engl and Capacity for Daily Living Scale ( S&E ADL Scale ) . RESULTS BBS score showed significant correlations with indicators of motor functioning , stage of disease , and daily living capacity . BBS score was inversely associated with the UPDRS motor score ( -.58 , P < .005 ) , Hoehn and Yahr Scale staging ( -.45 , P < .005 ) , and S&E ADL Scale rating ( .55 , P < .005 ) . In all 3 correlations , lower scores on the BBS ( indicating greater balance deficits ) correlated with higher UPDRS scores ( indicating greater motoric or functional impairment ) . CONCLUSIONS Results support the criterion-related validity of the BBS . Its utility in other balance conditions of older adults has been established . Rehabilitation interventions have been shown to improve the balance deficits associated with PD . Early referral and periodic re assessment is vital to achieving and maintaining improvements . Our research results agree with other published research in suggesting that the BBS may be used as a screening tool and ongoing assessment tool for patients with PD
These measures assess balance and falls risk prediction at the body , structure and function level , falls risk and balance , and falls risk at the activity level .
The motor examination of the Unified Parkinson ’s Disease Rating Scale ( UPDRS-ME ) with robust psychometric analysis is a condition-specific measure with acceptable properties .
Conclusion : Six of the 68 outcome measures have strong psychometric properties for the assessment of balance and falls risk prediction in PD .
Objective : To investigate the psychometric properties of measures of balance and falls risk prediction in people with Parkinson ’s disease ( PD ) .