Extrinsic and Behavioral Fall Risk Factors in People With Parkinson’s Disease: An Integrative Review

As rehab nurses, we know that our patients with Parkinson’s disease are at high risk for falling. As patients’ balance and coordination decline and there are increasing limits on their functional activities, the risk becomes greater. Kuljeerung & Lach use the person-environment fit framework to identify fall risk factors as intrinsic, extrinsic or behavioral in nature. Understanding the type of factors involved in a fall can help inform interventions to reduce falls in patients.

Abstract

Aim 

The aim of the study was to explore extrinsic and behavioral risks for falls in older adults with Parkinson’s disease (PD).

Background 

Falls that cause injury and disability in people with PD are common. Understanding the role of extrinsic and behavioral factors is important for fall prevention.

Design 

Integrative literature review with search of CINAHL, MEDLINE, and SCOPUS and ancestry searching was performed.

Methods 

The methodology of Whittemore and Knafl guided the review; ten studies were included.

Findings 

Falls occur indoors and outdoors, commonly during daily activities in familiar home environments, but also when out in the community. Common challenges include uneven and unfamiliar environments and risky behavior like hurrying.

Conclusion 

Extrinsic risk factors combined with behavioral and intrinsic factors contribute to falls in people with PD both at home and in the community.

Clinical Relevance 

Rehabilitation of people with PD should include assessment of falls, function, extrinsic risk factors, and fit with their environment to develop fall prevention plans.