Due to the nature of Parkinson’s disease, falls are a fairly common occurrence mainly due to instability with the posture and impaired gait. It has a host of complications as would frequent falls in any person, irrespective of Parkinson’s disease. However, bearing in mind that most Parkinson’s disease patients are older, the impact of these frequent falls can have severe consequences. Understanding the dangers associated with frequent falls and minimizing it is of the utmost importance.
Why do Parkinson’s disease patients fall so often?
Parkinson’s disease leads to rigidity, impaired balance and slowness of movement or freezing. This means that even when a Parkinson’s patient foresees a potential hazard, he/she cannot accommodate with rapid countermovements. The postural instability also means that a person cannot stay firmly planted when stationary or even when walking slowly and is therefore prone to falls and associated injuries. As the condition progresses, the frequency and often severity of falls increases proportionally. With time, a person loses his/her confidence and actually becomes more prone to falling by ‘second guessing’ their movements and countermovements when standing and walking. Orthostatic hypotension (postural low blood pressure) is also frequently seen in Parkinson’s disease and may also be cause of frequent falls although this association has not been conclusively proven. Visual problems also need to be taken into account as a possible cause of falls in Parkinson’s disease.
Effects of Frequent Falls
Falls are the second most common cause for hospitalization in Parkinson’s patients. Frequent falls may lead to repeated fractures and other soft tissue injury. Fractures are also more likely as osteoporosis is more common in older patients meaning that the bones are weaker. Fractures and related injuries lead to longer periods of immobilization which in itself has its own consequences such as depression, constipation, weakness, loss of confidence and insomnia. More severe falls can even lead to traumatic brain injury causing concussions, seizures and depending on the complications even contribute to death.
Tips for Preventing Frequent Falls
There is no single solution to preventing falls in Parkinson’s disease. In fact, it is not a matter of preventing falls entirely as this is common in life and particularly with old age, apart from the Parkinson’s disease component. Therefore the focus should be on preventing frequent falls and minimizing the extent of the injury. This involves a number of factors that both Parkinson’s disease patients and caregivers need to bear in mind :
- Take medication as prescribed to reduce the severity of motor symptoms.
- Consider safety tips advised for Parkinson’s patients and appropriate changes in the home environment that will limit falls and the extent of injuries.
- Some studies have shown that exercise and physical therapy may reduce the frequency of falls as it improves postural stability and balance.
- Always seek medical attention even after a minor fall to identify the full extent of injuries and have it treated immediately to limit the complications.
- Wear appropriate footwear that may be helpful in moving without restriction and enhancing postural stability. Heels should be avoided as far as possible.
- Never have both hands occupied when walking to ensure that one hand can grab onto surrounding objects and break the force of the fall.
- Do not get distracted while walking as even talking can be a contributing factor to falls since multitasking may be difficult for the Parkinson’s brain.