Level of Mobility Limitations and Falls Status in Persons With Multiple Sclerosis

Abstract

ObjectiveTo investigate whether fall rates are constant across levels of mobility limitations. DesignSecondary analysis of baseline assessments from a stratified randomized controlled trial. SettingCommunity. ParticipantsPersons with multiple sclerosis (N=365) were divided into 5 groups based on the mobility section of the Guy's Neurological Disability Scale (GNDS): no walking impairment (n=82); impaired walking, no aid (n=87); unilateral support (n=76); bilateral support to walk (n=78); or occasional wheelchair user (n=42). InterventionsNot applicable. Main Outcome MeasuresSelf-reported fall history (ie, retrospective) in the preceding 3 months. ResultsOne hundred twenty-four persons in the overall sample reported falling in the last 3 months (fall prevalence, 33.97%). Of the total sample, 17.8% reported 2 or more falls in the last 3 months. Chi-square analysis revealed a significant difference in the proportion of fallers across GNDS categories (χ2=42.64, P<.001). Post hoc analysis revealed that the group who walked with bilateral support had the greatest proportion of fallers (52.6%), while the group without walking impairment had the lowest proportion (15.9%). An examination of recurrent fallers as a function of group found that there were more recurrent fallers (70%) in the group that had a walking impairment but used no aid, relative to the other groups. ConclusionsThe current findings highlight that fall rates including recurrent fall prevalence are not uniform across mobility aid categories in persons with MS. Those using bilateral assistance for gait have the highest prevalence of fallers, and those with walking limitations and not yet using an aid had the greatest prevalence of multiple falls.