Discordance Between Balance Ability and Perception Is Associated With Falls in Parkinson's Disease: A Coordinated Analysis.
Jason K Longhurst, Andrew Hooyman, Merrill R Landers and 5 others
PMID 39601421WHAT IT FOUND
People with Parkinson's who were under-confident in their balance, despite their actual ability, were more likely to be fallers.
This discordance predicted falls better than balance tests or severity scores alone.
Key findings
01Discordance between actual and perceived balance was the only statistically significant factor associated with faller status.
02Under-confidence (perceiving lower balance ability than actual performance) was associated with a higher likelihood of being a faller.
03Standard measures like Timed Up and Go scores, age, and disease severity were not significantly associated with faller status in this model.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study relied on retrospective data, meaning falls were reported by memory rather than tracked prospectively, which introduces recall bias. Different studies used different protocols for the Timed Up and Go test (e.g., walking speed, distance, medication status), requiring statistical normalization that may not fully account for these variations. The Activities-Specific Balance Confidence scale has a ceiling effect, meaning it may not accurately distinguish high levels of confidence. The study design cannot prove that discordance causes falls; it only shows an association. The sample had generally higher balance confidence and faster walking times, so results may not apply to people with more severe Parkinson's disease.
Declared interests
The authors declare no conflicts of interest.
The easy way to misread this
Do not assume that under-confidence causes falls. This study shows an association using retrospective data, but it does not prove that the perception gap led to the fall. Additionally, the finding that Timed Up and Go scores were not significantly associated with falls in this specific model does not mean physical balance tests are useless; it highlights that perception adds unique information.