OBJECTIVE: To investigate falls prevalence, factors associated with falling and the effects of balance and strengthening interventions on falls in MSers.
DESIGN: 111 MSers who use bilateral support for gait were assessed with group and one-on-one physiotherapy .
MAIN OUTCOME MEASURES: Falls prevalence was assessed using retrospective recall. Demographic information, assessment of impairments of body function, Berg Balance Scale (BBS), 6 minute walk test (6MWT), multiple sclerosisimpact scale-29v2 (MSIS) physical and psychological scores and the modified fatigue impact scale(MFIS) were collected.
RESULTS: The prevalence of falls in a three month period was 50.5% of whom 28% had more than one fall. Fallers had greater physical (mean difference -3.9, p=0.048) and psychological (median difference -4.5, p=0.001) impact of MS and greater impact of fatigue (mean difference -9.4 p = 0.002). A logistic regression analysis found that the MFIS score made a unique significant contribution to the model (OR 1.048, 95% CI 1.018 to 1.079) correctly identifying 68% of fallers. A 10 week group physiotherapy intervention significantly reduced both the number of fallers (58.3% pre to 22.9% post, p=0.005) and the number of falls (63 pre, 25 post, p=0.001).
Epub: Socie et al. Footfall Placement Variability and Falls in Multiple Sclerosis. Ann Biomed Eng. 2012 Nov 7.
Background: Gait variability (i.e. fluctuations in walking) provides unique information about the control of movement and is associated with falls.
“Bone health and falls are a bit of a hobby horse of mine at the moment. I have 6 MSers under my care who have fallen in the last year and sustained fractures. If we are to make a difference to MSers we need to be proactive about falls and bone health and make sure that we try and prevent them, or at least reduce the danger of falls, and prevent fractures. This is part of my holistic approach to MS management drive. We have therefore developed an algorithm to address this problem that will eventually include a self-assessment tool to make sure you are empowered to assess your own risk of falling and of sustaining a fracture. As soon as it is published we will set-up a site for you to access. In the interim if you are a falling, or having near falls, please let your nurse or neurologist know. You may also need a bone density scan to make sure you don’t require treatment for osteopaenia (thin bones).”