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Lower Limb Strength Differentiates Between Fallers and Nonfallers With Multiple Sclerosis.

Heather M DelMastro1, Tracy Wall2, Deirdre J McPartland2

  • 1Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT; Department of Rehabilitative Medicine, Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT.

Archives of Physical Medicine and Rehabilitation
|January 11, 2025
PubMed
Summary
This summary is machine-generated.

Lower limb muscle weakness, particularly in the weakest limb, is a key indicator differentiating fallers from non-fallers in persons with multiple sclerosis (PwMS). Recurrent fallers show widespread weakness, highlighting the need for targeted strength interventions.

Keywords:
Accidental fallsLower extremityMultiple sclerosisMuscle strengthMuscle weaknessRehabilitation

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Area of Science:

  • Neurology
  • Rehabilitation Science
  • Movement Science

Background:

  • Falls are a significant concern for persons with multiple sclerosis (PwMS), impacting mobility and quality of life.
  • Understanding the biomechanical factors contributing to falls is crucial for developing effective prevention strategies.

Purpose of the Study:

  • To investigate if maximum voluntary contraction (MVC) of specific lower limb (LL) muscle groups can differentiate between PwMS with and without a history of falls.
  • To analyze differences in LL strength based on fall frequency (occasional vs. recurrent).

Main Methods:

  • A secondary analysis of a cross-sectional study involving 172 PwMS.
  • Lower limb MVC was measured for hip flexion, extension, abduction, knee flexion/extension, and ankle plantarflexion/dorsiflexion using a Biodex Dynamometer.
  • Participants were categorized into nonfallers (0 falls) and fallers (≥1 fall), with fallers further divided into occasional (1-2 falls) and recurrent (≥3 falls).

Main Results:

  • PwMS with a fall history demonstrated significantly lower strength in all measured LL muscle groups of the weakest limb (LL-W) and several in the strongest limb (LL-S) compared to nonfallers.
  • Recurrent fallers exhibited diminished strength across all LL-W and key LL-S groups (hip extension, flexion, abduction, ankle plantarflexion).
  • Occasional fallers showed reduced strength in hip abduction, knee flexion/extension of the weakest limb, and differed from recurrent fallers in hip extension of the weakest limb.

Conclusions:

  • Lower limb muscle weakness, especially in the weakest limb, is a significant differentiator between fallers and non-fallers in PwMS.
  • Fall frequency influences the pattern and extent of muscle weakness, with recurrent fallers showing more pronounced deficits.
  • These findings underscore the importance of assessing and addressing LL strength deficits in PwMS to inform clinical care and fall prevention strategies.