Pull test performance and correlation with falls risk in Parkinson's disease

Postural instability (PI) and falls are major sources of disability in Parkinson's disease (PD). Our objectives were to evaluate the correlation between the pull-test (PT) scores and falls. Patients underwent a standardized data collection including demographic, clinical data, and the UPDRS scores for falls and the PT. Cases with scores >1 for falls were considered frequent falters. 264 patients were included with mean age 67.6 +/- 10 years, mean age of onset 59.1 +/- 10.7 years. Comparison between PT scores versus the proportion of frequent fallers and the mean score of the UPDRS for falls showed that for each increase in the PT score, both parameters were significantly worse, with positive linear relationship. For any abnormal PT score, sensibility and negative predictive value were excellent; specificity and positive predictive value improved with worse PT scores. In conclusion, the PT provides important and reliable information regarding PI and the risk of falls in PD.