How does perceived fall risk influence decisions about whether to undertake activities in people with Parkinson's disease and their care partners? A qualitative study

Purpose To explore how perceptions of fall risk influence decisions to undertake activities in people with Parkinson's disease who have fallen, along with their care-partners. Materials and methods This qualitative study used semi-structured interviews to collect data from eight people with moderate to severe Parkinson's Disease and freezing of gait (including those with cognitive impairments) and their care-partners. An inductive approach to thematic analysis was used to analyse the data. Results Four main, interconnected themes emerged, and a framework was developed to illustrate these connections. Weighing up the risks and benefits reflected the constant tension between assessing the likelihood of falling and potential benefit of any activity; Being fearful heightened the perceived risk resulting in a tendency to avoid or modify activities; Desire to lead a normal life heightened the perceived benefit of any activity, leading towards risk taking behaviour; It's a part of Parkinson's provided the context in which the decision-making process took place, with the reality of a progressive disorder influencing choices and contributing to a belief that falls were inevitable. Conclusions There is a complex interaction between perceptions of fall risk and behaviour. An understanding of these interactions will assist therapists to tailor individualised fall prevention interventions.