Avoidance behavior mediates the relationship between concern about falling and impaired mobility in multiple...

Area of Science:

• Neurology
• Rehabilitation Science
• Movement Science

Background:

• Concern about falling (CAF) is a prevalent issue in multiple sclerosis (MS).
• CAF negatively impacts mobility and daily activities, irrespective of a fall history.
• Understanding factors contributing to mobility impairments in MS is crucial for effective interventions.

Purpose of the Study:

• To investigate the role of avoidance behavior in mediating the relationship between CAF and mobility impairments in MS.
• To determine if this mediation effect differs between individuals with MS who have fallen and those who have not.

Main Methods:

• Structural equation modeling was employed to test a mediation model.
• Participants completed validated questionnaires on CAF, avoidance behavior, and walking.
• Laboratory-based walking and balance assessments were conducted to objectively measure mobility.

Main Results:

• Avoidance behavior accounted for 46.96% of the total effect of CAF on mobility.
• The mediating role of avoidance behavior was statistically consistent between fallers and non-fallers.
• No significant differences in the mediation effect were observed based on fall history.

Conclusions:

• Avoidance behavior is a significant mediator of mobility impairments associated with CAF in MS.
• The impact of avoidance behavior on mobility is pervasive and consistent across individuals with MS, regardless of their fall status.
• Targeting avoidance behaviors may be a viable strategy to improve mobility in individuals with MS experiencing CAF.