Citation

Coote S, Hogan N, Franklin S. Arch. Phys. Med. Rehabil. 2013; 94(4): 616-621.

Affiliation

Department of Clinical Therapies & Centre for Physical Activity and Health Research, University of Limerick, Ireland. Electronic address: susan.coote@ul.ie.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.apmr.2012.10.020

PMID

23127308

Abstract

OBJECTIVE: To investigate falls prevalence, factors associated with falling and the effects of balance and strengthening interventions on falls in PwMS. DESIGN: Baseline and post treatment data from a RCT SETTING: Community PARTICIPANTS: 111 people with MS 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, assessment of impairments of body function, Berg Balance Scale(BBS), 6 minute walk test(6MWT), multiple sclerosis impact scale-29v2 (MSIS) physical and psychological scores and the modified fatigue impact scale(MFIS) were collected. RESULTS: The prevalence of falls in a three month period was 50.5% of whom 28% had more than one fall. Fallers had greater physical (mean difference -3.9, p=0.048) and psychological (median difference -4.5, p=0.001) impact of MS and greater impact of fatigue (mean difference -9.4 p = 0.002). A logistic regression analysis found that the MFIS score made a unique significant contribution to the model (OR 1.048, 95% CI 1.018 to 1.079) correctly identifying 68% of fallers. A 10 week group physiotherapy intervention significantly reduced both the number of fallers (58.3% pre to 22.9% post, p=0.005) and the number of falls (63 pre, 25 post, p=0.001). CONCLUSION: The prevalence of falls is high in this population of PwMS and fallers have significantly greater impact of MS and impact of fatigue. Development and evaluation of interventions to reduce falls risk and the transition to faller or multiple faller status is required.

Language: en