Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: A prospective cohort study

Journal article


Hoang, Phu D., Cameron, Michelle H., Gandevia, Simon C. and Lord, Stephen R.. (2014). Neuropsychological, balance, and mobility risk factors for falls in people with multiple sclerosis: A prospective cohort study. Archives of Physical Medicine and Rehabilitation. 95(3), pp. 480 - 486. https://doi.org/10.1016/j.apmr.2013.09.017
AuthorsHoang, Phu D., Cameron, Michelle H., Gandevia, Simon C. and Lord, Stephen R.
Abstract

Objectives: To determine whether impaired performance in a range of vision, proprioception, neuropsychological, balance, and mobility tests and pain and fatigue are associated with falls in people with multiple sclerosis (PwMS). Design: Prospective cohort study with 6-month follow-up. Setting: A multiple sclerosis (MS) physiotherapy clinic. Participants: Community-dwelling people (N=210; age range, 21–74y) with MS (Disease Steps 0–5). Interventions: Not applicable. Main Outcome Measures: Incidence of falls during 6 months' follow-up. Results: In the 6-month follow-up period, 83 participants (39.7%) experienced no falls, 57 (27.3%) fell once or twice, and 69 (33.0%) fell 3 or more times. Frequent falling (≥3) was associated with increased postural sway (eyes open and closed), poor leaning balance (as assessed with the coordinated stability task), slow choice stepping reaction time, reduced walking speed, reduced executive functioning (as assessed with the difference between Trail Making Test Part B and Trail Making Test Part A), reduced fine motor control (performance on the 9-Hole Peg Test [9-HPT]), and reported leg pain. Increased sway with the eyes closed, poor coordinated stability, and reduced performance in the 9-HPT were identified as variables that significantly and independently discriminated between frequent fallers and nonfrequent fallers (model χ23=30.1, P<.001). The area under the receiver operating characteristic curve for this model was .712 (95% confidence interval, .638–.785). Conclusions: The study reveals important balance, coordination, and cognitive determinants of falls in PwMS. These should assist the development of effective strategies for prevention of falls in this high-risk group.

Keywordsaccidental falls; multiple sclerosis; neuropsychological tests; postural balance; rehabilitation; risk factors
Year2014
JournalArchives of Physical Medicine and Rehabilitation
Journal citation95 (3), pp. 480 - 486
PublisherW.B. Saunders Co.
ISSN0003-9993
Digital Object Identifier (DOI)https://doi.org/10.1016/j.apmr.2013.09.017
Scopus EID2-s2.0-84896710139
Page range480 - 486
Research GroupSports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre
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File Access Level
Controlled
Place of publicationUnited States of America
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