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Abstract
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OBJECTIVE: This study evaluated the relationship between physiological and perceived fall risk in people with MS.
DESIGN: Secondary analysis of data from prospective cohort studies undertaken in Australia, United Kingdom and the United States. SETTING: Community PARTICIPANTS: 416 ambulatory people with MS (age 51.5 ±12.0 years; 73% female; 62% relapsing-remitting MS; 13.7 ±9.9 years disease duration). INTERVENTIONS: Not applicable OUTCOME MEASURES: All participants completed measures of physiological (Physiological Profile Assessment (PPA)) and perceived (Falls Efficacy Scale-international (FESi)) fall risk and prospectively recorded falls for three months.
RESULTS: 155 (37%) of the participants were recurrent fallers (≥2 falls). Mean PPA and FESi scores were high (PPA 2.14±1.87, FESi 34.27±11.18). The PPA and the FESi independently predicted faller classification in logistic regression, which indicated that the odds of being classified as a recurrent faller significantly increased with increasing scores (PPA Odds Ratio 1.30 (95%CI 1.17-1.46), FESi Odds Ratio 1.05 (95% CI 1.03-1.07)). Classification and regression tree analysis divided the sample into four groups based on cut-off values for the PPA: (1) low physiological/ low perceived risk (PPA <2.83, FESi <27.5), (2) low physiological/ high perceived risk (PPA <2.83, FESi >27.5), (3) high physiological/ low perceived risk (PPA >2.83, FESi <35.5), and (4) high physiological/ high perceived risk (PPA <2.83, FESi >35.5). Over 50% of participants had a disparity between perceived and physiological fall risk; most were in group 2. It is possible that physiological risk factors not detected by the PPA may also be influential.
CONCLUSION: This study highlights the importance of considering both physiological and perceived fall risk in MS, and that further research is needed to explore the complex inter-relationships of perceptual and physiological risk factors in this population. This study also supports the importance of developing behavioral and physical interventions which can be tailored to the individual's need.
Copyright © 2018. Published by Elsevier Inc.
Language: en |