Background Falls in people with multiple sclerosis (MS) are a serious health concern, and the percentage of people who restrict their activity because of concerns about falling (CAF) is not known. Mobility function and accumulated impairments are associated with fall risk in older adults but not in people with stroke and have not been studied in people with MS.
Objective The purposes of this study were: (1) to estimate the percentage of people who have MS and report falling, CAF, and activity restrictions related to CAF; (2) to examine associations of these factors with fall status; and (3) to explore associations of fall status with mobility function and number of accumulated impairments.
Design A cross-sectional survey was conducted.
Methods A total of 575 community-dwelling people with MS provided information about sociodemographics, falls, CAF, activity restrictions related to CAF, mobility function, and accumulated impairments. Chi-square statistics were used to explore associations among these factors.
Results In all participants, about 62% reported CAF and about 67% reported activity restrictions related to CAF. In participants who did not experience falls, 25.9% reported CAF and 27.7% reported activity restrictions related to CAF. Mobility function was associated with fall status; participants reporting moderate mobility restrictions reported the highest percentage of falls, and participants who were nonwalkers (ie, had severely limited self-mobility) reported the lowest percentage. Falls were associated with accumulated impairments; the participants who reported the highest percentage of 2 or more falls were those with 10 impairments.
Limitations This cross-sectional study relied on self-reported falls, mobility, and impairment status, which were not objectively verified.
Conclusions Both CAF and activity restrictions related to CAF were common in people with MS and were reported by people who experienced falls and those who did not. The association of fall status with mobility function did not appear to be linear. Fall risk increased with declining mobility function; however, at a certain threshold, further declines in mobility function were associated with fewer falls, possibly because of reduced fall risk exposure.
All authors provided concept/idea/research design. Dr Matsuda, Dr Shumway-Cook, Dr Ciol, and Dr Bombardier provided writing. Dr Matsuda, Dr Shumway-Cook, and Dr Ciol provided data analysis. Dr Bombadier provided fund procurement. Dr Shumway-Cook, Dr Bombardier, and Dr Kartin provided consultation (including review of manuscript before submission).
The authors would like to thank the University of Washington Aging With a Physical Disability Research Team as well as the University of Washington Multiple Sclerosis Rehabilitation Research Center.
All procedures were reviewed and approved by the Human Subjects Division of the University of Washington.
The abstract has been submitted to and accepted as a poster for the International Symposium on Gait and Balance in Multiple Sclerosis; October 1, 2011; Portland, Oregon; and the American Public Health Association meeting; October 29–November 1, 2011; Washington, DC.
The contents of this study were developed under a grant (H133B080024) from the Department of Education, National Institute on Disability and Rehabilitation Research (NIDRR), and Rehabilitation Research and Training Center on Aging With Disabilities. However, the contents do not necessarily represent the policy of the Department of Education, and endorsement by the Federal Government should not be assumed.
- Received November 9, 2010.
- Accepted October 27, 2011.
- © 2012 American Physical Therapy Association