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Predicting accidental falls in people with multiple sclerosis -- a longitudinal study.

Y Nilsagård1, Cecilia Lundholm, E Denison

  • 1Department of Physiotherapy, Orebro University Hospital and School of Health and Medical Sciences, Orebro University, Orebro, Sweden. ylva.nilsagard@orebroll.se

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Falls in multiple sclerosis (MS) are predicted by clinical factors like disability, spasticity, and balance. The Berg Balance Scale and Timed Up and Go cognitive test help identify individuals at higher risk of falling.

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Area of Science:

  • Neurology
  • Rehabilitation Medicine
  • Clinical Research

Background:

  • Accidental falls are a significant concern for individuals with multiple sclerosis (MS), impacting their mobility and quality of life.
  • Understanding the clinical factors associated with falls is crucial for developing effective prevention strategies.

Purpose of the Study:

  • To investigate accidental falls and near-fall incidents in people with MS.
  • To identify clinical variables and test results that predict fall risk in this population.

Main Methods:

  • A longitudinal, multi-centered cohort study involving 76 people with MS (Expanded Disability Status Scale 3.5-6.0).
  • Prospective collection of self-reported falls over three months post-standardized testing.
  • Evaluated Berg Balance Scale, Timed Up and Go cognitive, Four Square Step Test (FSST), and 12-item Multiple Sclerosis Walking Scale.

Main Results:

  • 63% of participants experienced 270 falls, primarily indoors during daily activities.
  • Fallers showed significant differences in Expanded Disability Status Score (EDSS), spasticity, proprioception, and use of walking aids.
  • Use of walking aids increased fall odds fivefold; impaired proprioception increased odds 2.5-15.6 times. EDSS and spasticity also significantly correlated with fall risk.

Conclusions:

  • Clinical assessment of walking aid use, proprioception, spasticity, EDSS, Berg Balance Scale, and Timed Up and Go cognitive are valuable for identifying individuals with MS who are at risk of falling.
  • These factors provide a basis for targeted interventions to reduce fall incidence in the MS population.