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Fear of Falling in People With Multiple Sclerosis: Which Clinical Characteristics Are Important?

Abstract

Background:
Fear of falling (FOF) is an important risk indicator for health-related outcomes and quality of life in patients with multiple sclerosis (MS). However, factors associated with FOF in MS are not well investigated.

Objectives:
This study was done to explore predictors of FOF in this population. Methods: Seventy relapsing remitting patients with MS were evaluated. Fear of falling was assessed using the Fall Efficacy Scale-International (FES-I). Motor outcomes included: 30-second chair stand test (30s-CST), Berg Balance Scale (BBS), 10-Meter Walk Test (10MWT), and 6-Minute Walk Test (6MWT). Cognitive status was determined using the Montréal Cognitive Assessment (MOCA) and Symbol Digit Modalities Test (SDMT). Affective factors including depression, fatigue, and sleep were also assessed using the Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS), and Pittsburgh Sleep Quality Index (PSQI), respectively.

Results:
Fear of falling was significantly correlated with all motor and affective measures used. However, a stepwise regression found that only BBS from motor measures, MOCA from cognitive measures, and sleep disorders from affective factors were significantly predictive of the FOF.

Conclusions:
Fear of falling in patients with MS is multifactorial and includes motor and nonmotor factors. Thus, therapies that aim to reduce risk of falling in this population should address motor functions, cognitive abilities, and sleep quality.

Acceptance Date Apr 11, 2017
Publication Date Jul 1, 2017
Journal Physical Therapy
Print ISSN 0031-9023
Publisher Oxford University Press
Pages 698 -706
DOI https://doi.org/10.1093/ptj/pzx044
Keywords accidental falls, adult, cognition disorders, cross-sectional studies, disability evaluation, exercise test, fear, female, humans, male, multiple sclerosis, relapsing-remitting, neuropsychological tests, severity of illness index, sleep wake disorders
Publisher URL https://doi.org/10.1093/ptj/pzx044

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