Postural Instability, Gait Disorders and Falls in Parkinson's Disease

Postural instability (PI) is a cardinal sign of Parkinson's disease (PD). Its importance increases with the disease progression. The most serious consequences of PI are recurrent falls that extremely worsen patients' quality of life and complications of which increase healthcare expenditure. The majority of falls occur in the patient's home environment and in a state of good mobility. Targeted history-taking and a specific clinical neurological assessment is needed to detect and follow-up PI. Pharmacotherapy has only a limited effect. Drugs working predominantly through the noradrenergic and cholinergic neurotransmitter system seem to be promising. Continuous "tailored" physiotherapy plays a key role in the treatment of PI and fall prevention in PD.