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.
Keywords
List of abbreviations:
BBS (Berg Balance Scale), GNDS (Guys Neurological Disability Rating Scale), MFIS (Modified Fatigue Impact Scale), MS (multiple sclerosis), MSIS-29v2 (Multiple Sclerosis Impact Scale-29 version 2), 6MWT (6-minute walk test)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 05, 2012
Footnotes
Supported by Multiple Sclerosis Ireland through the Getting the Balance Right Project.
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
Clinical Trial Registration Number: ISRCTN77610415.
Identification
Copyright
© 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
