@article{cefb59d322004c30bd6ea3cd6ea72d85,
title = "Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson's disease",
abstract = "Falls in Parkinson's disease (PD) are common and frequently devastating. Falls prevention is an urgent priority, but there is no accepted program that specifically addresses the risk profile in PD. Therefore, we aimed to provide consensus-based clinical practice recommendations that systematically address potential fall risk factors in PD. We developed an overview of both generic (age-related) and PD-specific factors. For each factor, we specified: best method of ascertainment; disciplines that should be involved in assessment and treatment; and which interventions could be engaged. Using a web-based tool, we asked 27 clinically active professionals from multiple relevant disciplines to evaluate this overview. The revised version was subsequently reviewed by 12 experts. Risk factors and their associated interventions were included in the final set of recommendations when at least 66% of reviewing experts agreed. These recommendations included 31 risk factors. Nearly all required a multidisciplinary team approach, usually involving a neurologist and PD-nurse specialist. Finally, the expert panel proposed to first identify the specific fall type and to tailor screening and treatment accordingly. A routine evaluation of all risk factors remains reserved for high-risk patients without prior falls, or for patients with seemingly unexplained falls. In conclusion, this project produced a set of consensus-based clinical practice recommendations for the examination and management of falls in PD. These may be used in two ways: for pragmatic use in current clinical practice, pending further evidence; and as the active intervention in clinical trials, aiming to evaluate the effectiveness and cost-effectiveness of large scale implementation.",
keywords = "Accidental falls, Clinical protocol, Parkinson's disease, Prevention",
author = "{van der Marck}, {Marjolein A.} and Klok, {Margit Ph C.} and Okun, {Michael S.} and Nir Giladi and Marten Munneke and Bloem, {Bastiaan R.} and Kelly Arney and Browner, {Nina M.} and Maggie Caunter and Cianci, {Heather J.} and Becky Dunlop and Karla Eggert and Beth Fisher and Hass, {Chris J.} and Christine Hunter and Mazen Jabre and Jeff Kraakevik and Lyons, {Kelly E.} and Fenna Phibbs and Scott, {Burton L.} and Ludy Shih and Tan, {Eng King} and Louis Tan and Sara Varanese and Tiffini Voss and Ann Ashburn and Claire Ballinger and Bhatti, {M. Tariq} and Jeff Hausdorff and Susanna Lindvall and Morris, {Meg E.} and Alice Nieuwboer and Schwalb, {Jason M.} and Stephanie Studenski and Wood, {Brian H.}",
note = "Funding Information: MSO : Dr. Okun serves as a consultant for the National Parkinson Foundation, and has received research grants from NIH, NPF, the Michael J. Fox Foundation, the Parkinson Alliance, Smallwood Foundation, and the UF Foundation. Dr. Okun has in the past >24 months received no support from industry including travel. Dr. Okun has received royalties for publications with Demos, Manson, and Cambridge (movement disorders books). Dr. Okun has participated in CME activities on movement disorders sponsored by the USF CME office, PeerView, Prime, and by Vanderbilt University. The institution and not Dr. Okun receives grants from Medtronic and ANS/St. Jude, and the PI has no financial interest in these grants. Dr. Okun has participated as a site PI and/or co-I for several NIH, foundation, and industry sponsored trials over the years but has not received honoraria. Funding Information: BRB was sponsored by ZonMw VIDI research grant (number 016.076.352 ). Funding Information: NG : Dr. Giladi and his department have received research grants from the NIH, EU, Michael J Fox Foundation, National Parkinson Foundation, Israel Science Office, Tel-Aviv University, Tel-Aviv Medical Centre. Dr. Giladi serves as a consultant on Advisory Boards for Teva-Lundbeck, UCB, NeuroDerm, Intec Pharma. As an advisor he has been getting honorarium for talks and travel support to meeting we he has personal contribution. Dr. Giladi has not been a PI on any industry supported clinical trials performed in his department and under his global responsibility. In none of the clinical trials he has been given any personal compensation or travel support. Funding Information: MAvdM was sponsored by NutsOhra Foundation, {\textquoteleft}Stichting Porticus{\textquoteright} and the NPF. ",
year = "2014",
month = apr,
doi = "10.1016/j.parkreldis.2013.10.030",
language = "English (US)",
volume = "20",
pages = "360--369",
journal = "Parkinsonism and Related Disorders",
issn = "1353-8020",
publisher = "Elsevier BV",
number = "4",
}