Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Future falls and/or near falls in people with Parkinson’s disease: Sensitivity and specificity of two retropulsion tests

Lindholm, Beata LU ; Hansson, Oskar LU orcid ; Duzynski, Wojciech LU ; Nilsson, Maria H LU orcid and Hagell, Peter LU (2013) International Congress of Parkinson's Disease and Movement Disorders, 2013 In Movement Disorders 28(S1). p.163-163
Abstract
Objective: To investigate the sensitivity and specificity of two retropulsion tests for identifying individuals with PD that will fall and/or experiencing near falls.
Background: People with PD have an increased risk for falls and experiencing near falls. They are particularly unstable backwards, and different retropulsion tests exist. Item 30 of the Unified Parkinson’s Disease Rating Scale (UPDRS) is most common, involving an expected shoulder pull. Others advocate using an unexpected shoulder pull, e.g. the Nutt Retropulsion test (NRT).
Methods: The study included 104 people with PD (mean age and PD-duration, 68 and 4.7 years, respectively) visiting a neurological clinic during 2006-2011. Those >80 years of age, requiring... (More)
Objective: To investigate the sensitivity and specificity of two retropulsion tests for identifying individuals with PD that will fall and/or experiencing near falls.
Background: People with PD have an increased risk for falls and experiencing near falls. They are particularly unstable backwards, and different retropulsion tests exist. Item 30 of the Unified Parkinson’s Disease Rating Scale (UPDRS) is most common, involving an expected shoulder pull. Others advocate using an unexpected shoulder pull, e.g. the Nutt Retropulsion test (NRT).
Methods: The study included 104 people with PD (mean age and PD-duration, 68 and 4.7 years, respectively) visiting a neurological clinic during 2006-2011. Those >80 years of age, requiring support in standing or did not understand the instructions were excluded. UPDRS and NRT assessments were conducted in the “on” condition. Participants then registered all falls and near falls by using a diary for six months. Based on this, participants were defined as “stable” (no falls/near falls) or “unstable” (≥1 fall / near fall). Sensitivity, specificity, positive and negative predictive values were calculated.
Results: Mean (SD) score for UPDRS III was 14.5 (8.1). Fifty-five (53%) participants were classified as “stable” and 49 (47%) as “unstable”. Both the NRT and item 30 (UPDRS) scores differed significantly (p=0.003) between the groups. Mean NRT and item 30 scores were 0.18 (0.51) and 0.33 (0.61) for the “stable” group versus 0.63 (0.88) and 0.71 (0.74) for the “unstable” group. Sensitivity/specificity were 37%/87% (NRT), and 55%/75% (UPDRS item 30). Positive/negative predictive values were 72%/61% (NRT) and 66%/65% (UPDRS item 30).
Conclusions: In this mildly affected sample, both NRT and item 30 had low sensitivity in detecting prospective falls and/or near falls over six months. Our findings speak against using either of these tests alone for this purpose and support previous recommendations of using multiple tests when targeting balance problems in people with PD.
(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Movement Disorders
volume
28(S1)
pages
163 - 163
publisher
John Wiley & Sons Inc.
conference name
International Congress of Parkinson's Disease and Movement Disorders, 2013
conference location
Sydney, Australia
conference dates
2013-06-16 - 2013-06-20
ISSN
0885-3185
language
English
LU publication?
yes
additional info
The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Active and Healthy Ageing Research Group (013220001), Clinical Memory Research Unit (013242610), Neurology, Malmö (013027010), Older people’s health and Person-Centred care (013220012)
id
e5247a02-f8bf-44d3-8b8b-e00a044ac390 (old id 3990774)
date added to LUP
2016-04-04 13:50:32
date last changed
2022-11-01 18:43:58
@misc{e5247a02-f8bf-44d3-8b8b-e00a044ac390,
  abstract     = {{Objective: To investigate the sensitivity and specificity of two retropulsion tests for identifying individuals with PD that will fall and/or experiencing near falls.<br/>Background: People with PD have an increased risk for falls and experiencing near falls. They are particularly unstable backwards, and different retropulsion tests exist. Item 30 of the Unified Parkinson’s Disease Rating Scale (UPDRS) is most common, involving an expected shoulder pull. Others advocate using an unexpected shoulder pull, e.g. the Nutt Retropulsion test (NRT). <br/>Methods: The study included 104 people with PD (mean age and PD-duration, 68 and 4.7 years, respectively) visiting a neurological clinic during 2006-2011. Those &gt;80 years of age, requiring support in standing or did not understand the instructions were excluded. UPDRS and NRT assessments were conducted in the “on” condition. Participants then registered all falls and near falls by using a diary for six months. Based on this, participants were defined as “stable” (no falls/near falls) or “unstable” (≥1 fall / near fall). Sensitivity, specificity, positive and negative predictive values were calculated.<br/> Results: Mean (SD) score for UPDRS III was 14.5 (8.1). Fifty-five (53%) participants were classified as “stable” and 49 (47%) as “unstable”. Both the NRT and item 30 (UPDRS) scores differed significantly (p=0.003) between the groups. Mean NRT and item 30 scores were 0.18 (0.51) and 0.33 (0.61) for the “stable” group versus 0.63 (0.88) and 0.71 (0.74) for the “unstable” group. Sensitivity/specificity were 37%/87% (NRT), and 55%/75% (UPDRS item 30). Positive/negative predictive values were 72%/61% (NRT) and 66%/65% (UPDRS item 30).<br/>Conclusions: In this mildly affected sample, both NRT and item 30 had low sensitivity in detecting prospective falls and/or near falls over six months. Our findings speak against using either of these tests alone for this purpose and support previous recommendations of using multiple tests when targeting balance problems in people with PD. <br/>}},
  author       = {{Lindholm, Beata and Hansson, Oskar and Duzynski, Wojciech and Nilsson, Maria H and Hagell, Peter}},
  issn         = {{0885-3185}},
  language     = {{eng}},
  note         = {{Conference Abstract}},
  pages        = {{163--163}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Movement Disorders}},
  title        = {{Future falls and/or near falls in people with Parkinson’s disease: Sensitivity and specificity of two retropulsion tests}},
  volume       = {{28(S1)}},
  year         = {{2013}},
}