PTOTCase-ControlJournal of physical therapy science2017

Factors inducing falling in schizophrenia patients.

Yoko Tsuji, Yoshiteru Akezaki, Kohei Mori and 7 others

PMID 28356628

WHAT IT FOUND

In 19 hospitalized patients with schizophrenia, those who had fallen showed poorer balance on the Time Up and Go test and one-leg stand, plus more medication side effects like drooling.

Antipsychotic drug dose itself did not differ between groups.

Key findings

01Patients who had fallen performed worse on the Time Up and Go test (8.7 seconds vs 6.6 seconds) and the one-leg stand with eyes open (4.7 seconds vs 19.9 seconds) compared to those who had not fallen.

02The fall group had significantly higher scores for sialorrhea (drooling), a side effect measured by the Drug Induced Extra-Pyramidal Symptoms Scale.

03There was no significant difference in the total daily antipsychotic drug dosage between patients who fell and those who did not.

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 included only 19 patients, making it very small and prone to chance findings. It was a cross-sectional design comparing fallers and non-fallers retrospectively, so it cannot prove that balance problems caused the falls. The wide variation in one-leg stand times (standard deviation of 21.5 seconds in the non-fall group) suggests highly uneven data. The study excluded patients using wheelchairs or with severe mental disorders, limiting applicability to the most impaired patients.

The easy way to misread this

Do not assume that lowering antipsychotic medication dosage will reduce fall risk, as the dose did not differ between fallers and non-fallers. Instead, the association with side effects like drooling suggests the type or individual sensitivity to medication may matter more than the total amount.

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