The impact of comorbid disease and injuries on resource use and expenditures in parkinsonism
Bloem BR, Munneke M, Carpenter MG, Allum JH. (2003) The impact of comorbid disease and injuries on resource use and expenditures in parkinsonism Neurology, Oct 14;61(7):1023; author reply 1023-4
This is a letter to the editor in response to the Pressley article (also reviewed in the Comorbidity section). They speciﬁcally discuss why patients with PD had fewer broken bones in their upper extremities as compared to their lower extremities. They suggest that patients with PD have decreased arm ﬂexion (arm movement away from the body) and increased adduction (arm movement towards the body), which possibly makes them more susceptible to broken hips as the patient may not be as easily able to reach out for a railing or to use their arms to break their fall. They hypothesize, that with this decreased arm involvement in a fall, a person will likely then land on either their hip or leg/knee thus causing more frequent lower extremity injuries. They suggest that due to falls and comorbid diseases with PD, intensive disease management is necessary for many patients.