@article{ref1,
title="The relationship between physiological and perceived fall risk in people with multiple sclerosis: implications for assessment and management",
journal="Archives of physical medicine and rehabilitation",
year="2018",
author="Gunn, Hilary and Cameron, Michelle and Hoang, Phu and Lord, Stephen and Shaw, Steve and Freeman, Jennifer",
volume="99",
number="10",
pages="2022-2029",
abstract="OBJECTIVE: This study evaluated the relationship between physiological and perceived fall risk in people with MS. <br><br>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. <br><br>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. <br><br>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.<br><br>Copyright © 2018. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2018.03.019",
url="http://dx.doi.org/10.1016/j.apmr.2018.03.019"
}