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
Authors | Hoang, Phu D., Cameron, Michelle H., Gandevia, Simon C. and Lord, Stephen R. |
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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. |
Keywords | accidental falls; multiple sclerosis; neuropsychological tests; postural balance; rehabilitation; risk factors |
Year | 2014 |
Journal | Archives of Physical Medicine and Rehabilitation |
Journal citation | 95 (3), pp. 480 - 486 |
Publisher | W.B. Saunders Co. |
ISSN | 0003-9993 |
Digital Object Identifier (DOI) | https://doi.org/10.1016/j.apmr.2013.09.017 |
Scopus EID | 2-s2.0-84896710139 |
Page range | 480 - 486 |
Research Group | Sports Performance, Recovery, Injury and New Technologies (SPRINT) Research Centre |
Publisher's version | File Access Level Controlled |
Place of publication | United States of America |
https://acuresearchbank.acu.edu.au/item/85v29/neuropsychological-balance-and-mobility-risk-factors-for-falls-in-people-with-multiple-sclerosis-a-prospective-cohort-study
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