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Relationship between physiological and perceived fall risk in people with multiple sclerosis: Implications for assessment and management
Gunn, Hilary Cameron, Michelle Hoang, Phu Lord, Stephen R. Shaw, Steve Freeman, Jennifer
Gunn, Hilary
Cameron, Michelle
Hoang, Phu
Lord, Stephen R.
Shaw, Steve
Freeman, Jennifer
Abstract
Objective: This study evaluated the relationship between physiological and perceived fall risk in people with multiple sclerosis (MS). Design: Secondary analysis of data from prospective cohort studies undertaken in Australia, the United Kingdom, and the United States. Setting: Community. Participants: Ambulatory people with MS (N=416) (age 51.5±12.0 years; 73% female; 62% relapsing-remitting MS; 13.7±9.9 years disease duration). Interventions: Not applicable. Main Outcome Measures: All participants completed measures of physiological (Physiological Profile Assessment [PPA]) and perceived (Falls Efficacy Scale-international [FESi]) fall risk and prospectively recorded falls for 3 months. Results: 155 (37%) of the participants were recurrent fallers (≥2 falls). Mean PPA and FESi scores were high (PPA 2.14±1.87, FESi 34.27±11.18). The PPA and the FESi independently predicted faller classification in logistic regression, which indicated that the odds of being classified as a recurrent faller significantly increased with increasing scores (PPA odds ratio [OR] 1.30 [95% CI 1.17-1.46], FESi OR 1.05 [95% CI 1.03-1.07]). Classification and regression tree analysis divided the sample into four groups based on cutoff values for the PPA: (1) low physiological/low perceived risk (PPA <2.83, FESi <27.5), (2) low physiological/high perceived risk (PPA <2.83, FESi >27.5), (3) high physiological/low perceived risk (PPA >2.83, FESi <35.5), and (4) high physiological/high perceived risk (PPA <2.83, FESi >35.5). Over 50% of participants had a disparity between perceived and physiological fall risk; most were in group 2. It is possible that physiological risk factors not detected by the PPA may also be influential. Conclusions: This study highlights the importance of considering both physiological and perceived fall risk in MS and the need for further research to explore the complex interrelationships of perceptual and physiological risk factors in this population. This study also supports the importance of developing behavioral and physical interventions that can be tailored to the individual’s needs.
Keywords
accidental falls, cohort studies, multiple sclerosis, rehabilitation
Date
2018
Type
Journal article
Journal
Archives of Physical Medicine and Rehabilitation
Book
Volume
99
Issue
10
Page Range
2022-2029
Article Number
ACU Department
School of Allied Health
Faculty of Health Sciences
Faculty of Health Sciences
Collections
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled