4.6 Article

Mobility and falls in people with Huntington's disease

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B M J PUBLISHING GROUP
DOI: 10.1136/jnnp.2008.147793

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Objective: The aim of this study was to estimate the frequency of falls in people with Huntington's disease (HD) and make a preliminary assessment of tools appropriate for assessing the risk of falling. Design: Observational study. Setting: Hospital clinic. Subjects: 24 people with HD. Main measures: Balance was assessed using the Berg Balance Scale (BBS) and Timed Up & Go'' (TUG) test. Walking speed over 10 m was recorded. Long-term monitoring of walking activity was undertaken. Unified Huntington Disease Rating Scale (UHDRS) motor, Functional Assessment Scale (FAS), Independence Scale (IS) and Total Functional Capacity (TFC) scores were obtained as well as data about falls and stumbles. Differences between recurrent fallers'' (>= 2 falls/year) and non-fallers'' (<= 1 fall/year) for the range of outcome measures were investigated and probabilities calculated. Results: Mean (SD) age (years) of people with HD (n = 24) tested was 56.6 (11.7) and BMI (kg/m(2)) 24.7 (5.5). Median (range) UHDRS motor scores were 48 (28 80). Ten (41.6%) patients reported (1 fall and 14 (58.3%) >= 2 falls in the previous 12 months. Recurrent fallers walked less (p < 0.01) and slower than non-fallers. Their balance (BBS) (p < 0.01) was worse and TUG scores were higher (p < 0.01). People with HD had increased risk of falls if TUG scores were >= 14 s or BBS scores <= 40. Conclusion: A high proportion of HD patients have recurrent falls, and the BBS and TUG appear to be useful in falls risk assessment.

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