Extrinsic and Behavioral Fall Risk Factors in People With Parkinson’s Disease: An Integrative Review

Abstract Aim The aim of the study was to explore extrinsic and behavioral risks for falls in older adults with Parkinson’s disease (PD). Background Falls that cause injury and disability in people with PD are common. Understanding the role of extrinsic and behavioral factors is important for fall prevention. Design Integrative literature review with search of CINAHL, MEDLINE, and SCOPUS and ancestry searching was performed. Methods The methodology of Whittemore and Knafl guided the review; ten studies were included. Findings Falls occur indoors and outdoors, commonly during daily activities in familiar home environments, but also when out in the community. Common challenges include uneven and unfamiliar environments and risky behavior like hurrying. Conclusion Extrinsic risk factors combined with behavioral and intrinsic factors contribute to falls in people with PD both at home and in the community. Clinical Relevance Rehabilitation of people with PD should include assessment of falls, function, extrinsic risk factors, and fit with their environment to develop fall prevention plans.