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  • Title: Falls in people with multiple sclerosis who use a walking aid: prevalence, factors, and effect of strength and balance interventions.
    Author: Coote S, Hogan N, Franklin S.
    Journal: Arch Phys Med Rehabil; 2013 Apr; 94(4):616-21. PubMed ID: 23127308.
    Abstract:
    OBJECTIVES: To investigate falls prevalence, factors associated with falling, and the effects of balance and strengthening interventions on falls in persons with multiple sclerosis (MS). DESIGN: Baseline and posttreatment data from a randomized controlled trial. SETTING: Community. PARTICIPANTS: People with MS (N=111) who use bilateral support for gait. INTERVENTIONS: Group and one-on-one physiotherapy. MAIN OUTCOME MEASURES: Falls prevalence was assessed using retrospective recall. Demographic information was collected, impairments of body function were assessed, and results from the Berg Balance Scale, 6-minute walk test (6MWT), Multiple Sclerosis Impact Scale-29 version 2 physical and psychological scores, and the Modified Fatigue Impact Scale (MFIS) were obtained. RESULTS: The prevalence of falls in a 3-month period was 50.5% among participants with MS, of whom 28% had more than 1 fall. Fallers had a greater physical (mean difference, -3.9; P=.048) and psychological (median difference, -4.5; P=.001) impact of MS and a greater impact of fatigue (mean difference, -9.4; P=.002). A logistic regression analysis found that the MFIS score made a unique, significant contribution to the model (odds ratio=1.04; 95% confidence interval, 1.018-1.079), correctly identifying 68% of fallers. A 10-week group physiotherapy intervention significantly reduced both the number of fallers (58.3% before to 22.9% after intervention, P=.005) and the number of falls (63 before to 25 after intervention, P=.001). CONCLUSIONS: The prevalence of falls is high in this population of persons with MS, and the impact of MS and of fatigue is greater in fallers. Development and evaluation of interventions to reduce falls risk and the transition to faller or multiple faller status are required.
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