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Motor Cognitive Dual-Task Testing to Predict Future Falls in Multiple Sclerosis: A Systematic Review.
Libak Abou1, Joseph Peters2,3, Nora E Fritz4
1Department of Physical Medicine & Rehabilitation, Michigan Medicine, University of Michigan, Ann Arbor, MI, USA.
Neurorehabilitation and Neural Repair
|November 2, 2022
Summary
Dual-task testing, combining gait or balance with cognitive tasks, is not yet a reliable predictor of future falls in people with multiple sclerosis (PwMS). Further research is needed to determine its clinical utility for fall risk assessment in this population.
Area of Science:
- Neurology
- Rehabilitation Science
- Clinical Neuroscience
Background:
- Mobility and cognitive impairments increase fall risk in people with multiple sclerosis (PwMS).
- Predicting falls in PwMS using concurrent gait/balance and cognitive assessments (dual-task) lacks consistent evidence.
Approach:
- A systematic literature search was conducted across seven major databases (PubMed, Embase, Web of Science, Scopus, CINHAL, SPORTDiscuss, PsycINFO) up to May 2022.
- Studies involving adults with multiple sclerosis performing dual-task testing and prospectively monitoring falls for at least three months were included.
- Two independent reviewers identified eligible studies and assessed their quality.
Key Points:
- Eight studies with 484 participants were reviewed.
- Most studies found dual-task testing and dual-task cost ineffective in discriminating fallers from non-fallers.
- Dual-task walking velocity cost and dual-task correct response rate in serial 7 subtraction were associated with recurrent falls.
- Cognitive-motor interference patterns also correlated with increased fall risk.
Conclusions:
- Current evidence suggests dual-task testing is insufficient for predicting future falls in people with multiple sclerosis.
- More research involving complex tasks and extended fall monitoring is necessary to establish dual-task testing as a clinical tool for fall prediction in PwMS.
