Risk of fall in Parkinson's Disease is the most common risk factor in patients diagnosed by Parkinson's Disease, in this presentation am going to address the role of the physical therapy in order to prevent falls.

1. Preventive Measures in
Parkinson's Disease
Under supervision of:
Prof. Dr. Eda Tonga
Prepared by: Hussein Youssef
MS. Student – Marmara University

2. Objectives of the seminar:
• Identify the threating factors for PD patients.
• Investigate fall risk and its prevention.
• Recognize the multiple ways of fall prevention.
• Different diet restrictions and recommendations.

3. Fall in healthy population (geriatrics):
• For a fall to occur, a person must be
performing an activity.
Moving from the bed to the
bathroom in the evening. The fall
may occur because:
1. The older person has poor eye
sight (intrinsic).
2. Moving in a hurry to move from
their bedroom to the toilet
(activity).
3. Tripped on a carpet in the
bedroom (extrinsic).
Environment modulation is important to decrease the risk of fall

4. Fall frequency in PD:
MIDDLE
Posture/gait decline
EARLY
Weak association
falls/activity
LATE
People not active
So, it’s very important to identify the PD stage to be considered
in the rehabilitation

5. Risk factors of falls

6. Falls in PD: Postural Control and Gait
• Dual task performance is also known as “concurrent performance” and involves
the execution of a secondary task, which is the major focus of attention, and a
primary (motor) task performed at the same time.
‘Stop walking while talking’ study by Lundin- Olsson (1997) showed
that the inability to maintain a conversation while walking is a
marker of future falls in older nursing home resident.

7. Activity VS Falls:
 Type of ACTIVITY:
• During gait
• Single task / Dual task
• Turning
• Lateral –backward gait
• FOG episodes

8. Falls prevention

9. Treadmill training + virtual reality:

10. Different protocols to be considered:
• Functional Training: an exercise program should be based on focused
practice of functional skills.
• Motor-Cognitive Dual-Task Training
• Balance training

11. Diet and PD medications can impact each other:
• Sugary foods and drinks.
• Avoid high protein diet. Consuming lots of beef, fish, or cheese may affect the
effectiveness of certain Parkinson’s medications and may interfere with the
absorption.
• Avoid meals with much sodium, trans fat, cholesterol, and saturated fats.
• Avoid consumption of alcohol use.
• Coffee could have a neuroprotective effect and reduces the risk of Alzheimer's
disease as well as PD
• Bananas contain about 32 mg of magnesium, so you can eat one or two a day
• Berries: high levels of antioxidants.

12. References
• Physical Rehabilitation 7th edition, Susan B. O’Sullivan, ,2019

13. Any questions?

14. Thanks for your attention
Hussein Ahmed Youssef - Teaching Assistant - PT - HUE