Fear of falling impairs spatiotemporal gait parameters, mobility, and quality of life in Parkinson's disease: a cross-sectional study

Abstract

Background: Fear of Falling (FOF) significantly affects Parkinson's Disease (PD) patients by limiting daily activities and reducing quality of life (QoL). Though common in PD, the relation between FOF, mobility, and QoL remains unclear. This study examines the connections between FOF, gait, daily motor activity, and QoL in PD patients.

Methods: Fifty PD patients on stable levodopa therapy were enrolled, excluding those with dementia or walking impairments. Assessments included UPDRS-III, Hoehn and Yahr, MoCA, Berg Balance scale, Geriatric Depression Scale and Fall Efficacy Scale International (FES-I). QoL was evaluated using PDQ39. The Timed-Up-and-Go (TUG) test was performed at regular and fast paces, with data collected via smartphone apps for TUG gait parameters and for 24-h quantity of movement monitoring (Activity Index, AIX). A subgroup of 10 patients also underwent 24-h gait monitoring.

Results: FOF was found in 38% of patients, correlating with worse motor scores and QoL (UPDRS-III, 26 vs 17, p < 0.0001; PDQ39 36 vs 14, p < 0.0001). FOF patients showed slower walking (0.73 m/s vs 1.13 m/s, p < 0.001), reduced step length (0.151 vs 0.220 m, p < 0.001), and poorer adaptation to fast walking and environment (being unable to vary their speed and frequency). FOF and sex were both associated with a reduced mobility QoL, with a significant contribution of AIX only in women (r -0.648, p = 0.012).

Conclusions: This study supports the existence of a significant correlation between FOF, motor activity and QoL in PD, especially in women, emphasize the need for targeted interventions, early rehabilitation and prospective studies focusing on gender.

Keywords: Gait; Parkinson’s disease; Quality of Life; Rehabilitation; Remote patient monitoring.