Rapid assessment of postural instability in Parkinson's disease (RAPID): A pilot study

R. K.Y. Chong, J. Morgan, S. H. Mehta, I. Pawlikowska, P. Hall, A. V. Ellis, A. D. Ibanez-Won, G. M. Miller, K. Baugh, K. Sethi

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Background: The Fahn's pull (or retropulsion) test is an item in the motor section of the Unified Parkinson's Disease Rating Scale, which is used almost exclusively to classify postural instability in Parkinson's disease (PD). However, the test is hard to standardize and is often performed incorrectly, making it hard to interpret. Moreover, it may not be safe to administer in patients who experience pain in the shoulders, neck, trunk and/or lower extremities. Identifying and grading postural instability in PD without requiring a physical challenge would not only be useful for the clinician but would assist patients and caregivers in its recognition. We propose the use of the rapid assessment of postural instability in Parkinson's disease (RAPID) questionnaire as a non-physical assessment tool.Methods: We determined the associations between the pull test and items on a risk-assessment questionnaire that consisted of three parts: activities of daily living, fear of falling, and frequency of falling.Results: Significant correlations were found between the pull test and the predictor variables, which ranged between 0.51 and 0.56 whilst the correlations amongst the predictor variables ranged between 0.58 and 0.70. The three parts of the questionnaire, when used in combination, produced a 96% sensitivity in the classification of postural instability.Conclusions: The RAPID questionnaire can be used as an adjunct to the pull test or solely if the pull test is contraindicated. It may also be possible to administer the questionnaire via the telephone or Internet. It is hoped that the rapid identification of postural instability would lead to fewer falls.

Original languageEnglish (US)
Pages (from-to)260-265
Number of pages6
JournalEuropean Journal of Neurology
Volume18
Issue number2
DOIs
StatePublished - Feb 1 2011

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Parkinson Disease
Accidental Falls
Shoulder Pain
Activities of Daily Living
Telephone
Internet
Caregivers
Fear
Lower Extremity
Neck
Surveys and Questionnaires

Keywords

  • Falls
  • Fear of falling
  • Pull test
  • Questionnaire

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Rapid assessment of postural instability in Parkinson's disease (RAPID) : A pilot study. / Chong, R. K.Y.; Morgan, J.; Mehta, S. H.; Pawlikowska, I.; Hall, P.; Ellis, A. V.; Ibanez-Won, A. D.; Miller, G. M.; Baugh, K.; Sethi, K.

In: European Journal of Neurology, Vol. 18, No. 2, 01.02.2011, p. 260-265.

Research output: Contribution to journalArticle

Chong, RKY, Morgan, J, Mehta, SH, Pawlikowska, I, Hall, P, Ellis, AV, Ibanez-Won, AD, Miller, GM, Baugh, K & Sethi, K 2011, 'Rapid assessment of postural instability in Parkinson's disease (RAPID): A pilot study', European Journal of Neurology, vol. 18, no. 2, pp. 260-265. https://doi.org/10.1111/j.1468-1331.2010.03115.x
Chong, R. K.Y. ; Morgan, J. ; Mehta, S. H. ; Pawlikowska, I. ; Hall, P. ; Ellis, A. V. ; Ibanez-Won, A. D. ; Miller, G. M. ; Baugh, K. ; Sethi, K. / Rapid assessment of postural instability in Parkinson's disease (RAPID) : A pilot study. In: European Journal of Neurology. 2011 ; Vol. 18, No. 2. pp. 260-265.
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