Parkinson Disease and Orthostatic Hypotension in the Elderly: Recognition and Management of Risk Factors for Falls

LeWitt Peter A, Kymes Steve, Hauser Robert A

Table 4 Non-pharmacologic Interventions That May Reduce OH/nOH Symptoms or General Fall Risk in PD.

Interventions Address OH/nOH Symptoms Address General Fall Reduction in PD Physical counter-maneuvers [37,87,89] •Leg crossing with active muscle tensing •Bending forward, arms crossed over the abdomen •Squatting •Lower-body muscle tensing after squatting Compression garments [26,87,89] •Abdominal or full-body compression garments Other [24,26,89] •Sleeping with elevation of the head end of the bed (6-9 inches) •Liberal intake of salt, up to 10 g of sodium/day •Adequate hydration (target 2-3 L/day) •Oral water bolus (500 mL) Assistive devices/safety measures for general fall reduction [37,86] •Walking frames •Canes that can be folded into a tripod chair •Handrails Physical therapy or symptoms of PD that may affect fall risk [77,78,85] •Vestibular training, Lee Silverman Voice Training BIG (LSVT-BIG)