High incidence of falls in patients with myotonic dystrophy type 1 and 2: A prospective study

Autor: Fran H.P. Smulders, A.A. Tieleman, Joost Raaphorst, Joost Berends, Baziel G.M. van Engelen, Nicol C. Voermans, Corinne G.C. Horlings
Přispěvatelé: Neurology, Amsterdam Neuroscience - Neurodegeneration
Rok vydání: 2019
Předmět:
Adult
Male
musculoskeletal diseases
0301 basic medicine
congenital
hereditary
and neonatal diseases and abnormalities
Pediatrics
medicine.medical_specialty
Myotonic dystrophy
Head trauma
03 medical and health sciences
All institutes and research themes of the Radboud University Medical Center
0302 clinical medicine
medicine
Humans
Myotonic Dystrophy
Clinical significance
Prospective Studies
Prospective cohort study
Genetics (clinical)
Balance (ability)
Muscle Weakness
business.industry
Incidence (epidemiology)
Age Factors
Muscle weakness
Middle Aged
Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3]
medicine.disease
030104 developmental biology
Neurology
Pediatrics
Perinatology and Child Health
Accidental Falls
Female
Neurology (clinical)
medicine.symptom
business
030217 neurology & neurosurgery
Fall prevention
Zdroj: Neuromuscular Disorders, 29, 758-765
Neuromuscular disorders, 29(10). Elsevier Limited
Neuromuscular Disorders, 29, 10, pp. 758-765
ISSN: 0960-8966
DOI: 10.1016/j.nmd.2019.08.012
Popis: We aimed to examine the incidence as well as the circumstances and the consequences of falling in adult patients with myotonic dystrophy type 1 and 2 (DM1/DM2). We performed a prospective cohort study in 209 subjects, of which 102 had DM1, 42 had DM2 and 65 healthy controls. An assessment of their falls was carried out during 100 consecutive days. In addition, falls during the previous year were reported. The primary outcome measure was the number of self-reported falls per participant during these 100 days. The secondary outcome measures included self-reported causes, circumstances and consequences of the falls. Mean (SD) falls per participant in 100 days was seven- to eightfold higher in patients with DM1 (0.74 (0.14)) and DM2 (0.62 (0.20)) compared to the controls (0.09 (0.04); p < 0.001)). Sixteen percent of DM1 and 17% of DM2 patients fell at least twice. Two-thirds of the falls occurred inside. Fifty percent of falls resulted in an injury, including a head trauma in four patients. Compared to non-fallers, those patients who fell were older (DM1/DM2), had a lower DM1-Activ score (DM1), had more muscle weakness (DM1), and reported less confidence in balance (DM1). This study demonstrates a high incidence and clinical relevance of falling in patients with DM1 and DM2. Fall prevention strategies in both DM1 and DM2 should focus on adaptations of the home environment and the patient's interaction in this environment.
Databáze: OpenAIRE
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