Citation

Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Phys. Ther. 2013; 93(4): 504-513.

Affiliation

H.J. Gunn, School of Health Professions, Plymouth University, Plymouth, United Kingdom.

Copyright

(Copyright © 2013, American Physical Therapy Association)

DOI

10.2522/ptj.20120231

PMID

23237970

Abstract

BACKGROUND: Falls are a significant issue in Multiple Sclerosis (MS), with research demonstrating falls rates of more than 50%. PURPOSE: To evaluate the risk factors associated with falling in people with MS. DATA SOURCES: Mixed search methods were used including computer based and manual searches. Additionally, hand searches of reference lists and conference abstracts were performed. All literature published from their earliest date to January 2012 was included; only English language sources (or those where a translation was available), where full text was available, were included. STUDY SELECTION: Eligibility criteria specified articles evaluating any aspect of falls risk in adults with a confirmed MS diagnosis, where the incidence of falling as determined by prospective or retrospective participant report was included. DATA EXTRACTION: Data were extracted independently by two reviewers using a written protocol and standardized extraction documentation. Detailed assessment of each article was independently undertaken by both reviewers, including assessment of study quality using an adaptation of the Newcastle Ottawa Scale plus extraction of key data (participant characteristics, falls incidence and outcomes). DATA SYNTHESIS: The final review comprised eight papers with a total of 1,929 participants; 1,037 (53.75%) were classified as fallers. Eighteen different risk factors were assessed within the included studies. Meta-analysis demonstrated an increase in falls risk associated with impairments of balance and cognition, progressive MS and use of a mobility aid. Narrative review of the qualitative papers and those factors where meta-analysis was not possible was also undertaken. LIMITATIONS: Variation in assessment, analysis, and reporting methods only allowed meta-analysis for four factors. CONCLUSION: There is limited evidence of the factors associated with falls risk in MS; further methodologically robust studies are required.

Language: en