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  1. Article: Cervical dystonia: disease profile and clinical management.

    Crowner, Beth E

    Physical therapy

    2007  Volume 87, Issue 11, Page(s) 1511–1526

    Abstract: Cervical dystonia, the most common focal dystonia, frequently results in cervical pain and disability as well as impairments affecting postural control. The predominant treatment for cervical dystonia is provided by physicians, and treatment can vary ... ...

    Abstract Cervical dystonia, the most common focal dystonia, frequently results in cervical pain and disability as well as impairments affecting postural control. The predominant treatment for cervical dystonia is provided by physicians, and treatment can vary from pharmacological to surgical. Little literature examining more conservative approaches, such as physical therapy, exists. This article reviews the etiology and pathophysiology of the disease as well as medical and physical therapist management for people with cervical dystonia.
    MeSH term(s) Anti-Dyskinesia Agents/therapeutic use ; Baclofen/therapeutic use ; Botulinum Toxins/therapeutic use ; Deep Brain Stimulation ; Denervation ; Diagnosis, Differential ; Humans ; Injections, Spinal ; Muscle Relaxants, Central/therapeutic use ; Physical Examination ; Physical Therapy Modalities ; Proprioception/physiology ; Torticollis/diagnosis ; Torticollis/etiology ; Torticollis/physiopathology ; Torticollis/therapy
    Chemical Substances Anti-Dyskinesia Agents ; Muscle Relaxants, Central ; Botulinum Toxins (EC 3.4.24.69) ; Baclofen (H789N3FKE8)
    Language English
    Publishing date 2007-11
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 415886-6
    ISSN 0031-9023
    ISSN 0031-9023
    DOI 10.2522/ptj.20060272
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Essential content for teaching implementation practice in healthcare: a mixed-methods study of teams offering capacity-building initiatives.

    Reszel, Jessica / Daub, Olivia / Leese, Jenny / Augustsson, Hanna / Bellows, Danielle Moeske / Cassidy, Christine E / Crowner, Beth E / Dunn, Sandra I / Goodwin, Lisa B / Hoens, Alison M / Hunter, Sarah C / Lynch, Elizabeth A / Moore, Jennifer L / Rafferty, Miriam R / Romney, Wendy / Stacey, Dawn / Graham, Ian D

    Implementation science communications

    2023  Volume 4, Issue 1, Page(s) 151

    Abstract: ... study participants described offering applied and pragmatic content (e.g., tools and resources), and ...

    Abstract Background: Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals' and teams' ability to apply implementation science in practice is through training and professional development opportunities (capacity-building initiatives). Although there is an increasing demand for and offerings of implementation practice capacity-building initiatives, there is no universal agreement on what content should be included. In this study we aimed to explore what capacity-building developers and deliverers identify as essential training content for teaching implementation practice.
    Methods: We conducted a convergent mixed-methods study with participants who had developed and/or delivered a capacity-building initiative focused on teaching implementation practice. Participants completed an online questionnaire to provide details on their capacity-building initiatives; took part in an interview or focus group to explore their questionnaire responses in depth; and offered course materials for review. We analyzed a subset of data that focused on the capacity-building initiatives' content and curriculum. We used descriptive statistics for quantitative data and conventional content analysis for qualitative data, with the data sets merged during the analytic phase. We presented frequency counts for each category to highlight commonalities and differences across capacity-building initiatives.
    Results: Thirty-three individuals representing 20 capacity-building initiatives participated. Study participants identified several core content areas included in their capacity-building initiatives: (1) taking a process approach to implementation; (2) identifying and applying implementation theories, models, frameworks, and approaches; (3) learning implementation steps and skills; (4) developing relational skills. In addition, study participants described offering applied and pragmatic content (e.g., tools and resources), and tailoring and evolving the capacity-building initiative content to address emerging trends in implementation science. Study participants highlighted some challenges learners face when acquiring and applying implementation practice knowledge and skills.
    Conclusions: This study synthesized what experienced capacity-building initiative developers and deliverers identify as essential content for teaching implementation practice. These findings can inform the development, refinement, and delivery of capacity-building initiatives, as well as future research directions, to enhance the translation of implementation science into practice.
    Language English
    Publishing date 2023-11-27
    Publishing country England
    Document type Journal Article
    ISSN 2662-2211
    ISSN (online) 2662-2211
    DOI 10.1186/s43058-023-00525-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Essential content for teaching implementation practice in healthcare

    Jessica Reszel / Olivia Daub / Jenny Leese / Hanna Augustsson / Danielle Moeske Bellows / Christine E. Cassidy / Beth E. Crowner / Sandra I. Dunn / Lisa B. Goodwin / Alison M. Hoens / Sarah C. Hunter / Elizabeth A. Lynch / Jennifer L. Moore / Miriam R. Rafferty / Wendy Romney / Dawn Stacey / Implementation Practice CBI Study Team / Ian D. Graham

    Implementation Science Communications, Vol 4, Iss 1, Pp 1-

    a mixed-methods study of teams offering capacity-building initiatives

    2023  Volume 20

    Abstract: Abstract Background Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying ... ...

    Abstract Abstract Background Applying the knowledge gained through implementation science can support the uptake of research evidence into practice; however, those doing and supporting implementation (implementation practitioners) may face barriers to applying implementation science in their work. One strategy to enhance individuals’ and teams’ ability to apply implementation science in practice is through training and professional development opportunities (capacity-building initiatives). Although there is an increasing demand for and offerings of implementation practice capacity-building initiatives, there is no universal agreement on what content should be included. In this study we aimed to explore what capacity-building developers and deliverers identify as essential training content for teaching implementation practice. Methods We conducted a convergent mixed-methods study with participants who had developed and/or delivered a capacity-building initiative focused on teaching implementation practice. Participants completed an online questionnaire to provide details on their capacity-building initiatives; took part in an interview or focus group to explore their questionnaire responses in depth; and offered course materials for review. We analyzed a subset of data that focused on the capacity-building initiatives’ content and curriculum. We used descriptive statistics for quantitative data and conventional content analysis for qualitative data, with the data sets merged during the analytic phase. We presented frequency counts for each category to highlight commonalities and differences across capacity-building initiatives. Results Thirty-three individuals representing 20 capacity-building initiatives participated. Study participants identified several core content areas included in their capacity-building initiatives: (1) taking a process approach to implementation; (2) identifying and applying implementation theories, models, frameworks, and approaches; (3) learning implementation steps and skills; (4) developing ...
    Keywords Implementation practice ; Capacity-building initiatives ; Mixed-methods ; Training content and curriculum ; Medicine (General) ; R5-920
    Subject code 690
    Language English
    Publishing date 2023-11-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: Prospective study examining remote effects of botulinum toxin a in children with cerebral palsy.

    Crowner, Beth E / Racette, Brad A

    Pediatric neurology

    2008  Volume 39, Issue 4, Page(s) 253–258

    Abstract: We examined the remote effects on muscle strength and functional decline of lower-extremity botulinum toxin A injections in children with cerebral palsy. This prospective study enrolled 34 children (19 boys, 15 girls; mean age, 7.7 years) diagnosed with ... ...

    Abstract We examined the remote effects on muscle strength and functional decline of lower-extremity botulinum toxin A injections in children with cerebral palsy. This prospective study enrolled 34 children (19 boys, 15 girls; mean age, 7.7 years) diagnosed with spastic cerebral palsy. Patients were examined at baseline and 1 month to determine if they experienced a change in upper-extremity strength (handheld dynamometry) or function (Pediatric Outcomes Data Collection Instrument). Subjects were analyzed in aggregate and by dosing group (low dose, 0-10 U/kg body weight; high dose, 11-25 U/kg) to determine if injection dose was associated with a change in remote muscle strength or function. We measured baseline and 1-month postinjection strength in shoulder flexor, shoulder abductor, elbow flexor, elbow extensor, and finger flexor muscles. None of these remote muscle groups was significantly weaker at 1 month after injection. No correlation was evident between change in muscle strength and toxin dose. These findings indicate that doses of botulinum toxin A in the lower extremities, at up to 21 U/kg, do not affect upper-extremity strength. This information can help guide dosages of botulinum toxin A in the management of spasticity in children with cerebral palsy.
    MeSH term(s) Adolescent ; Botulinum Toxins, Type A/administration & dosage ; Botulinum Toxins, Type A/therapeutic use ; Brain Damage, Chronic/drug therapy ; Brain Damage, Chronic/physiopathology ; Cerebral Palsy/drug therapy ; Cerebral Palsy/physiopathology ; Child ; Child, Preschool ; Dose-Response Relationship, Drug ; Female ; Follow-Up Studies ; Humans ; Injections, Intramuscular ; Lower Extremity ; Male ; Motor Skills/drug effects ; Motor Skills/physiology ; Muscle Spasticity/drug therapy ; Muscle Spasticity/physiopathology ; Muscle Strength/drug effects ; Muscle Strength/physiology ; Muscle, Skeletal/drug effects ; Muscle, Skeletal/physiopathology ; Neurologic Examination/methods ; Neuromuscular Agents/administration & dosage ; Neuromuscular Agents/therapeutic use ; Prospective Studies ; Treatment Outcome ; Upper Extremity
    Chemical Substances Neuromuscular Agents ; Botulinum Toxins, Type A (EC 3.4.24.69)
    Language English
    Publishing date 2008-10
    Publishing country United States
    Document type Clinical Trial ; Journal Article
    ZDB-ID 639164-3
    ISSN 1873-5150 ; 0887-8994
    ISSN (online) 1873-5150
    ISSN 0887-8994
    DOI 10.1016/j.pediatrneurol.2008.07.003
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Utility of the Mini-BESTest, BESTest, and BESTest sections for balance assessments in individuals with Parkinson disease.

    Leddy, Abigail L / Crowner, Beth E / Earhart, Gammon M

    Journal of neurologic physical therapy : JNPT

    2011  Volume 35, Issue 2, Page(s) 90–97

    Abstract: Background and purpose: The Balance Evaluation Systems Test(BESTest) has been shown to be a reliable and valid measure of balance in individuals with Parkinson disease (PD). A less time-consuming assessment may increase clinical utility. We compared the ...

    Abstract Background and purpose: The Balance Evaluation Systems Test(BESTest) has been shown to be a reliable and valid measure of balance in individuals with Parkinson disease (PD). A less time-consuming assessment may increase clinical utility. We compared the discriminative fall risk ability of the Mini-BESTest with that of the BESTest and determined the reliability and normal distribution of scores for each section of the BESTest and the Mini-BESTest in individuals with PD.
    Methods: Eighty individuals with idiopathic PD were assessed using the BESTest and Mini-BESTest. A faller was defined as an individual with 2 or more falls in the prior 6 months. Subsets of individuals were used to determine interrater (n = 15) and test-retest reliability (n = 24).
    Results: The Mini-BESTest, total BESTest score, and all sections of the BESTest showed a significant difference between the average scores of fallers and nonfallers. For both the Mini-BESTest and BESTest, interrater (intraclass correlation ICC ≥ 0.91) and test-retest (ICC ≥ 0.88) reliability was high. The Mini-BESTest and BESTest were highly correlated (r = 0.955). Accuracy of identifying a faller was comparable for the Mini-BESTest and BESTest (area under the receiver operating characteristic plots = 0.86 and 0.84, respectively).
    Discussion: No specific section of the BESTest captured the primary balance deficit for individuals with PD. The posttest probabilities for discriminating fallers versus nonfallers were comparable-to-slightly stronger when using the Mini-BESTest.
    Conclusion: Although the Mini-BESTest has fewer than half of the items in the BESTest and takes only 15 minutes to complete, it is as reliable as the BESTest and has comparable-to-slightly greater discriminative properties for identifying fallers in individuals with PD.
    MeSH term(s) Accidental Falls ; Aged ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/physiopathology ; Postural Balance/physiology ; Predictive Value of Tests ; Reproducibility of Results ; Risk Assessment
    Language English
    Publishing date 2011-09-21
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2276921-3
    ISSN 1557-0584 ; 1557-0576 ; 1085-049X
    ISSN (online) 1557-0584
    ISSN 1557-0576 ; 1085-049X
    DOI 10.1097/NPT.0b013e31821a620c
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: What is backward disequilibrium and how do i treat it? A complex patient case study.

    Scheets, Patricia L / Sahrmann, Shirley A / Norton, Barbara J / Stith, Jennifer S / Crowner, Beth E

    Journal of neurologic physical therapy : JNPT

    2015  Volume 39, Issue 2, Page(s) 119–126

    Abstract: Background and purpose: Postural vertical refers to a component of an individual's perception of verticality that is derived from information about the direction of gravitational forces. Backward disequilibrium (BD) is a postural disorder observed in ... ...

    Abstract Background and purpose: Postural vertical refers to a component of an individual's perception of verticality that is derived from information about the direction of gravitational forces. Backward disequilibrium (BD) is a postural disorder observed in some older adults who have a distortion in their perception of postural vertical. Individuals with BD sustain their center of mass (COM) posterior to their base of support and resist correction of COM alignment. The purposes of this case study are to describe a patient with BD and propose a physical therapy management program for this condition.
    Case description and intervention: The patient was an 83-year-old woman admitted for home care services 4 months after falling and sustaining a displaced right femoral neck fracture and subsequent hemiarthroplasty. Details of the clinical examination, diagnosis, and intervention are provided and a treatment protocol for physical therapy management is suggested.
    Outcomes: During the episode of care, the patient (1) decreased her dependence on caregivers, (2) surpassed minimal detectable change or minimal clinically important improvements in gait speed and on the Short Physical Performance Battery and Performance-Oriented Mobility Assessment, and (3) achieved her primary goal of staying in her own apartment at an assisted living facility.
    Discussion: Knowledge of BD coupled with a thorough clinical examination may assist physical therapists in identifying this condition and employing the specific intervention we have proposed. We believe that failure to recognize and manage our patient's condition appropriately would have led to nursing home placement.Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A94).
    MeSH term(s) Aged, 80 and over ; Exercise Therapy/methods ; Female ; Humans ; Movement Disorders/therapy ; Postural Balance/physiology
    Language English
    Publishing date 2015-04
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2276921-3
    ISSN 1557-0584 ; 1557-0576 ; 1085-049X
    ISSN (online) 1557-0584
    ISSN 1557-0576 ; 1085-049X
    DOI 10.1097/NPT.0000000000000084
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Functional gait assessment and balance evaluation system test: reliability, validity, sensitivity, and specificity for identifying individuals with Parkinson disease who fall.

    Leddy, Abigail L / Crowner, Beth E / Earhart, Gammon M

    Physical therapy

    2010  Volume 91, Issue 1, Page(s) 102–113

    Abstract: Background: Gait impairments, balance impairments, and falls are prevalent in individuals with Parkinson disease (PD). Although the Berg Balance Scale (BBS) can be considered the reference standard for the determination of fall risk, it has a noted ... ...

    Abstract Background: Gait impairments, balance impairments, and falls are prevalent in individuals with Parkinson disease (PD). Although the Berg Balance Scale (BBS) can be considered the reference standard for the determination of fall risk, it has a noted ceiling effect. Development of ceiling-free measures that can assess balance and are good at discriminating "fallers" from "nonfallers" is needed.
    Objective: The purpose of this study was to compare the Functional Gait Assessment (FGA) and the Balance Evaluation Systems Test (BESTest) with the BBS among individuals with PD and evaluate the tests' reliability, validity, and discriminatory sensitivity and specificity for fallers versus nonfallers.
    Design: This was an observational study of community-dwelling individuals with idiopathic PD.
    Methods: The BBS, FGA, and BESTest were administered to 80 individuals with PD. Interrater reliability (n=15) was assessed by 3 raters. Test-retest reliability was based on 2 tests of participants (n=24), 2 weeks apart. Intraclass correlation coefficients (2,1) were used to calculate reliability, and Spearman correlation coefficients were used to assess validity. Cutoff points, sensitivity, and specificity were based on receiver operating characteristic plots.
    Results: Test-retest reliability was .80 for the BBS, .91 for the FGA, and .88 for the BESTest. Interrater reliability was greater than .93 for all 3 tests. The FGA and BESTest were correlated with the BBS (r=.78 and r=.87, respectively). Cutoff scores to identify fallers were 47/56 for the BBS, 15/30 for the FGA, and 69% for the BESTest. The overall accuracy (area under the curve) for the BBS, FGA, and BESTest was .79, .80, and .85, respectively.
    Limitations: Fall reports were retrospective.
    Conclusion: Both the FGA and the BESTest have reliability and validity for assessing balance in individuals with PD. The BESTest is most sensitive for identifying fallers.
    MeSH term(s) Accidental Falls/prevention & control ; Accidental Falls/statistics & numerical data ; Discriminant Analysis ; Female ; Gait ; Gait Disorders, Neurologic/diagnosis ; Gait Disorders, Neurologic/etiology ; Humans ; Male ; Middle Aged ; Neurologic Examination/standards ; Parkinson Disease/complications ; Parkinson Disease/physiopathology ; Postural Balance ; Predictive Value of Tests ; ROC Curve ; Risk Assessment/methods ; Risk Factors ; Sensitivity and Specificity
    Language English
    Publishing date 2010-11-11
    Publishing country United States
    Document type Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Validation Study
    ZDB-ID 415886-6
    ISSN 1538-6724 ; 0031-9023
    ISSN (online) 1538-6724
    ISSN 0031-9023
    DOI 10.2522/ptj.20100113
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article: Iatrogenic botulism due to therapeutic botulinum toxin a injection in a pediatric patient.

    Crowner, Beth E / Brunstrom, Janice E / Racette, Brad A

    Clinical neuropharmacology

    2007  Volume 30, Issue 5, Page(s) 310–313

    Abstract: Botulinum toxin A is commonly used to reduce spasticity and dystonia in children with cerebral palsy. We report a pediatric patient who developed systemic botulism as a result of a severe overdose of the injected toxin (40 U/kg). This case highlights the ...

    Abstract Botulinum toxin A is commonly used to reduce spasticity and dystonia in children with cerebral palsy. We report a pediatric patient who developed systemic botulism as a result of a severe overdose of the injected toxin (40 U/kg). This case highlights the importance of physicians having adequate knowledge of primate and human literature on the lethal dose, 50% of botulinum toxin A before injecting children.
    MeSH term(s) Botulinum Toxins, Type A/adverse effects ; Botulism/chemically induced ; Cerebral Palsy/drug therapy ; Child, Preschool ; Female ; Humans
    Chemical Substances Botulinum Toxins, Type A (EC 3.4.24.69)
    Language English
    Publishing date 2007-09
    Publishing country United States
    Document type Case Reports ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 199293-4
    ISSN 1537-162X ; 0362-5664
    ISSN (online) 1537-162X
    ISSN 0362-5664
    DOI 10.1097/WNF.0b013e31804b1a0d
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The use of botulinum toxin therapy for lower-extremity spasticity in children with cerebral palsy.

    Criswell, Susan R / Crowner, Beth E / Racette, Brad A

    Neurosurgical focus

    2006  Volume 21, Issue 2, Page(s) e1

    Abstract: Hypertonicity is a leading cause of disability for children with cerebral palsy (CP). Botulinum toxin A (BTA) chemically denervates muscle tissue and is commonly used in the management of lower-extremity hypertonicity in children with CP because of its ... ...

    Abstract Hypertonicity is a leading cause of disability for children with cerebral palsy (CP). Botulinum toxin A (BTA) chemically denervates muscle tissue and is commonly used in the management of lower-extremity hypertonicity in children with CP because of its focal effects and wide safety margin. Randomized controlled trials have demonstrated that BTA injections in the ankle flexors, hamstrings, and adductors reduce spasticity and result in improved passive and active range of motion. In other studies, improvements in gait and measurements of functional outcome were found in appropriately selected children who had been injected with BTA. A multidisciplinary treatment approach that includes physical therapists, occupational therapists, orthotists, neurologists, physicians with expertise in performing botulinum toxin injections, orthopedic surgeons, and neurosurgeons is critical to optimize care in children with lower-extremity tone due to CP. In this paper, the authors propose treatment algorithms based on clinical presentation, detailed dosing, and technical information to optimize the treatment of these children. With a multidisciplinary approach, children with lower-extremity hypertonicity due to CP can experience improvements in muscle tone and function.
    MeSH term(s) Algorithms ; Anti-Dyskinesia Agents/therapeutic use ; Botulinum Toxins/therapeutic use ; Cerebral Palsy/complications ; Cerebral Palsy/drug therapy ; Child ; Child, Preschool ; Humans ; Lower Extremity ; Muscle Spasticity/drug therapy ; Muscle Spasticity/etiology ; Randomized Controlled Trials as Topic ; Treatment Outcome
    Chemical Substances Anti-Dyskinesia Agents ; Botulinum Toxins (EC 3.4.24.69)
    Language English
    Publishing date 2006-08-15
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2026589-X
    ISSN 1092-0684 ; 1092-0684
    ISSN (online) 1092-0684
    ISSN 1092-0684
    DOI 10.3171/foc.2006.21.2.2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Relative mortality in U.S. Medicare beneficiaries with Parkinson disease and hip and pelvic fractures.

    Harris-Hayes, Marcie / Willis, Allison W / Klein, Sandra E / Czuppon, Sylvia / Crowner, Beth / Racette, Brad A

    The Journal of bone and joint surgery. American volume

    2014  Volume 96, Issue 4, Page(s) e27

    Abstract: Background: Parkinson disease is a neurodegenerative disease that affects gait and postural stability, resulting in an increased risk of falling. The purpose of this study was to estimate mortality associated with demographic factors after hip or pelvic ...

    Abstract Background: Parkinson disease is a neurodegenerative disease that affects gait and postural stability, resulting in an increased risk of falling. The purpose of this study was to estimate mortality associated with demographic factors after hip or pelvic (hip/pelvic) fracture in people with Parkinson disease. A secondary goal was to compare the mortality associated with Parkinson disease to that associated with other common medical conditions in patients with hip/pelvic fracture.
    Methods: This was a retrospective observational cohort study of 1,980,401 elderly Medicare beneficiaries diagnosed with hip/pelvic fracture from 2000 to 2005 who were identified with use of the Beneficiary Annual Summary File. The race/ethnicity distribution of the sample was white (93.2%), black (3.8%), Hispanic (1.2%), and Asian (0.6%). Individuals with Parkinson disease (131,215) were identified with use of outpatient and carrier claims. Cox proportional hazards models were used to estimate the risk of death associated with demographic and clinical variables and to compare mortality after hip/pelvic fracture between patients with Parkinson disease and those with other medical conditions associated with high mortality after hip/pelvic fracture, after adjustment for race/ethnicity, sex, age, and modified Charlson comorbidity score.
    Results: Among those with Parkinson disease, women had lower mortality after hip/pelvic fracture than men (adjusted hazard ratio [HR] = 0.63, 95% confidence interval [CI]) = 0.62 to 0.64), after adjustment for covariates. Compared with whites, blacks had a higher (HR = 1.12, 95% CI = 1.09 to 1.16) and Hispanics had a lower (HR = 0.87, 95% CI = 0.81 to 0.95) mortality, after adjustment for covariates. Overall, the adjusted mortality rate after hip/pelvic fracture in individuals with Parkinson disease (HR = 2.41, 95% CI = 2.37 to 2.46) was substantially elevated compared with those without the disease, a finding similar to the increased mortality associated with a diagnosis of dementia (HR = 2.73, 95% CI = 2.68 to 2.79), kidney disease (HR = 2.66, 95% CI = 2.60 to 2.72), and chronic obstructive pulmonary disease (HR = 2.48, 95% CI = 2.43 to 2.53).
    Conclusions: Mortality after hip/pelvic fracture in Parkinson disease varies according to demographic factors. Mortality after hip/pelvic fracture is substantially increased among those with Parkinson disease.
    MeSH term(s) Age Factors ; Aged ; Aged, 80 and over ; Female ; Hip Fractures/mortality ; Humans ; Male ; Medicare ; Parkinson Disease/mortality ; Pelvic Bones/injuries ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Sex Factors ; United States
    Language English
    Publishing date 2014-02-20
    Publishing country United States
    Document type Journal Article
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.L.01317
    Database MEDical Literature Analysis and Retrieval System OnLINE

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