A cross-sectional study examining multiple mobility device use and fall status among middle-aged and older adults with multiple sclerosis

Abstract

Purpose: To document the prevalence of multiple mobility device use among adults with multiple sclerosis (MS) (≥55 years) and examine the association between falls status (faller/non-faller) and the number of mobility devices used. Methods: Cross-sectional data generated through telephone interviews with 353 participants was used for this secondary analysis. Descriptive statistics were used to address the first study purpose. Multiple device use was measured by the number of devices used, which ranged from 0 (never use a cane, walker, manual wheelchair, or power wheelchair/scooter) to 4 (use all four mobility devices at least some of the time). Logistic regression analysis was used to address the second purpose, with fall status used as the dependent variable (non-fallers [<1 per year] versus fallers [≥1 per year]). Results: Just under 60% of participants reported the use of at least two mobility devices. For each additional mobility device used, the odds of being a faller increased by 1.47 times (95% CI = 1.14–1.90). Conclusion: Multiple mobility device use was common and the greater number of devices used, the greater the likelihood of being a faller. To prevent falls, this association requires further research to determine directionality.Implications for RehabilitationThe high prevalence of multiple mobility device use points to the importance of asking about all devices a person uses, not just the primary one.Regression findings point to the need for comprehensive fall risk assessment and raise questions about whether different approaches to fall prevention intervention may be required for different clients.Including discussions and education about how to select the “right” device for different activities may be useful in the context of improving mobility status and reducing fall risk. Adequate practice with each device and “refreshers” when a device is not used to regularly may also be valuable.