Background Maintaining balance and mobility is a challenge in Huntington's disease.1 The balance and walking problems result in increased fall risk during the course of the disease.2 Falls are common. Contributing factors include bradykinesia of gait, stride variability and chorea as well as cognitive and behavioural issues.3 The “Physiotherapy Guidance Document” of the European Huntington's Disease Network describes all measurement instruments which can be used in Huntington's disease. Until now no fall risk screening tool has been identified as most accurate and reliable.
Aims Description of correlation between actual falls and three fall risk screening tools: Berg Balance Scale, Tinetti and Timed Up and Go Test.
Methods Data of 28 patients from our outpatient clinic were used. Fall risk was assessed using Berg Balance Scale (BBS), Timed Up and Go (TUG) and Tinetti. Patients were scored on falling by asking patient and care giver (“fallers” (≥2 falls/year) or “non-fallers” (≤1 fall/year)).
Results 16 of the 28 patients were “fallers”. 18 patients lived at home and 17 patients had physiotherapy. The TUG showed a relatively strong significant relation (0.458; p=0.02) with falling. The BBS, Tinetti and TUG significantly correlated with each other (r=0.693–0.862; p<0.01).
Conclusions In this small group of patients the TUG showed a significant correlation with actual falls. The three tests appeared to correlate well with each other. More research needs to be done in a larger group of patients to establish the sensitivity and specificity of the tests for Huntington's disease patients.
References 1. Tian J, Herdman SJ, Zee DS, et al. Postural stability in patients with Huntington's disease. Neurology 1992;42:1232–8.
2. Busse ME, Wiles CM, Rosser AE. Mobility and Falls in Huntington's Disease. J Neurol Neurosurg Psychiatry 2009;80:88–90.
3. Grimbergen YA, Knol MJ, Bloem BR, et al. Falls and gait disturbances in Huntington's disease. Mov Disord 2008;23:970–6.
- Huntington's disease
- fall risk
- screening tools