Effect of Fear of Falling on Mobility Measured During Lab and Daily Activity Assessments in Parkinson's Disease

In Parkinson’s disease (PD), fear of falling (FOF) is linked to falls and reduced quality of life. Inertial measurement units (IMUs) allow assessment of mobility during lab tests and daily activities, but the effect of FOF has not been studied in both settings simultaneously. We evaluated mobility in 26 PD patients during clinical tests and 14 days of home monitoring, extracting gait, sit-to-stand, and turn parameters from lower-back IMUs. FOF was assessed using the Falls Efficacy Scale-International, and patients were grouped as PD-FOF+ or PD-FOF-. Mobility differences were analyzed using logistic regression and effect sizes (Wilcoxon test). The peak angular velocity of the turn-to-sit transition during the TUG test best distinguished groups (effect size r = 0.61). PD-FOF+ also tended to have lower gait speed and fewer walking bouts at home, especially short bouts. Combining lab and home parameters increased discriminative power (AUC = 0.75) compared with lab (AUC = 0.68) or home (AUC = 0.54) alone. PD-FOF+ showed higher gait speeds in lab tests than at home. These results indicate that mobility measures from both settings improve detection of FOF in PD. Despite the limited sample, this study highlights the value of combining clinical and home-based assessments to guide prevention and treatment strategies for PD patients.