Mobility, balance and falls in persons with multiple sclerosis.

Jacob J Sosnoff,Robert W Motl,Morgan K Boes,Michael J Socie,Brian M Sandroff,Swathi Balantrapu,Yoojin Suh,Steven Morrison,John H Pula,Madeline Weikert

doi:10.1371/journal.pone.0028021

Jacob J Sosnoff, Robert W Motl + Show 8 more

Open Access

https://doi.org/10.1371/journal.pone.0028021

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Journal: PloS one	Publication Date: Nov 22, 2011
Citations: 222	License type: CC BY 4.0

Affiliation: University of Illinois Urbana-Champaign, Illinois College

Abstract

BackgroundThere is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS). This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS).Methods52 ambulatory persons with MS (PwMS) participated in the investigation. All persons provided demographic information including fall history over the last 12 months. Disease status was assessed with Expanded Disability Status Scale (EDSS). Walking speed, coordination, endurance and postural control were quantified with a multidimensional mobility battery.ResultsOver 51% of the participants fell in the previous year with 79% of these people being suffering recurrent falls. Overall, fallers were older, had a greater prevalence of assistive devices use, worse disability, decreased walking endurance, and greater postural sway velocity with eyes closed compared to non-fallers. Additionally, fallers had greater impairment in cerebellar, sensory, pyramidal, and bladder/bowel subscales of the EDSS.ConclusionsThe current observations suggest that PwMS who are older, more disabled, utilize an assistive device, have decreased walking coordination and endurance and have diminished balance have fallen in the previous year. This suggests that individuals who meet these criteria need to be carefully monitored for future falls. Future research is needed to determine a prospective model of falls specific to PwMS. Additionally, the utility of interventions aimed at reducing falls and fall risk in PwMS needs to be established.

Highlights

Over 50% of persons with multiple sclerosis (PwMS) report falling over a 6-month period [1,2,3] and routinely require medical attention for fall-related injuries [3,4,5]
Twenty-nine participants (55.8% of the sample) reported at least one fall in the previous 12 months with a further twenty-three of these 29 fallers (79% of fallers) reporting two or more falls in the same period
The differences between groups were moderate to large in magnitude based on effect sizes for age (d = 20.66) and MS duration (d = 20.80)

Summary

Introduction

Over 50% of persons with multiple sclerosis (PwMS) report falling over a 6-month period [1,2,3] and routinely require medical attention for fall-related injuries [3,4,5]. Despite the adverse impact that falls can have on PwMS, there have been few direct investigations of the factors that contribute to falls in this high risk population. One major area of concern relates to the lack of information regarding any association between falls and objective measures of balance and gait in this population. The purpose of the current investigation was to determine the relation between fall history and clinical (EDSS and subcomponents), demographic (age, gender), mobility (walking speed, endurance, and coordination) and postural sway metrics in PwMS. There is a lack of information concerning the relation between objective measures of gait and balance and fall history in persons with MS (PwMS) This investigation assessed the relation between demographic, clinical, mobility and balance metrics and falls history in persons with multiple sclerosis (MS)

Results

Discussion

Conclusion