Associations Between Objective, Functional, and Self-Reported Balance Assessments and Fall Frequency in Parkinson's Disease

Abstract

Background Falls are common in Parkinson's disease (PD) and reduce quality of life. Numerous balance assessment tools evaluate fall risk; however, data on their relationship with fall frequency are limited. Aims To investigate the relationship between fall frequency and objective, functional, and self-reported balance assessment tools in PD patients. Methods This cross-sectional study included 40 PD patients (Hoehn and Yahr stages 1-3). Fall frequency was recorded using a fall diary. Objective balance was assessed with the Biodex Balance System, functional balance with the Mini-Balance Evaluation Systems Test (Mini-BESTest), and perceived balance confidence with the Falls Efficacy Scale-International (FES-I). Results Fall frequency was weakly correlated with the Overall Stability Index (r = 0.338, p = 0.033) and the dynamic gait subdomain of the Mini-BESTest (r = 0.331, p = 0.037) and moderately correlated with FES-I scores (r = 0.572, p < 0.001). Binary logistic regression revealed that the FES-I score was a significant independent predictor of faller status (chi & sup2;= 12.41, p < 0.001, Nagelkerke R & sup2; = 0.357); each one-point increase in FES-I score increased the odds of being a faller by 15.5% (OR = 1.16, 95% CI: 1.05-1.28, p = 0.005). Conclusions Fall frequency was associated with all balance assessments, with the self-report measure demonstrating a moderate association that was greater in magnitude than those observed for the objective and functional assessments. These findings indicate that clinical evaluation of fall risk should incorporate self-report tools reflecting activity and participation limitations and contextual factors, alongside laboratory-based and functional assessments.