Fear of falling and falls in people with Parkinson's disease treated with deep brain stimulation in the subthalamic nuclei

Background - No previous study prospectively investigated the effects of subthalamic deep brain stimulation on fear of falling (FOF) and falls. Aim - The aim was to prospectively explore whether FOF and fall rate were affected after STN stimulation in people with Parkinson's disease (PD). Methods - Twenty participants (mean age: 65 , SD 6.4) were included. Falls and near falls were recorded (fall diary) during 3 months before and 1 year after surgery. FOF was evaluated using the Falls-Efficacy Scale, Swedish version, FES(S), and the modified Survey of Activities and Fear of Falling in the Elderly (SAFFE). Results- After surgery, the FES(S) scores of complex activities improved (P = 0.026), i.e. median 34 (q1-q3, 26-50) vs 43 (32-55). SAFFE scores also improved (P = 0.007): median 25 (22-30) versus 22 (18-27). The rate of near falls decreased (P = 0.014). Nine participants reported no near falls. For the remaining ten participants, the median near fall rate decreased from 6 (3-17) to 2 (1-8). The rate of falls showed no significant (P > 0.3) difference. Conclusions - After surgery, fewer activities were avoided owing to the risk of falling, and fall-related self-efficacy had improved during complex activities. The rate of near falls decreased. The results cannot support any change in fall rate.