Gillian Quinn1,2, Laura Comber1, Chris McGuigan3, Ailish Hannigan4, Rose Galvin1, Susan Coote1. 1. School of Allied Health, Health Research Institute, University of Limerick, Limerick, Ireland. 2. Physiotherapy Department, St. James's Hospital, Dublin, Ireland. 3. Neurology Department, St. Vincent's University Hospital, Dublin, Ireland. 4. School of Medicine, Health Research Institute, University of Limerick, Limerick, Ireland.
Abstract
OBJECTIVE: To identify risk factors for falling for people with Multiple Sclerosis. DESIGN: Prospective cohort study. SETTING: Neurology service in a tertiary hospital. SUBJECTS: Participants were 101 people with Multiple Sclerosis and Expanded Disability Status Score of 3-6.5. One participant withdrew after the baseline assessment; data were analysed for 100 participants. INTERVENTIONS: No intervention. MAIN MEASURES: Outcome was rate of falls, and predictors were Timed Up and Go, Symbol Digit Modalities test, demographics and 15 self-report questions about various symptoms including fatigue, concentration, dual tasking, bladder and bowel control. Three-month prospective diaries recorded falls. RESULTS: There were 791 falls reported over the 3-month period from a total of 56 fallers. Falls rate per person-year was 32.08 falls. Following multivariable regression analysis, the model with the greatest levels of clinical utility and discriminative ability (sensitivity 88% and area under the receiving operating curve statistic = 0.72, 95% CI 0.62-0.82), included the variables of history of a fall, not having visual problems, problems with bladder control and a slower speed on the Timed Up and Go. CONCLUSION: This study confirms the high incidence of falls for people with Multiple Sclerosis and provides a risk prediction model including fall history, problems with bladder control, not having visual problems and a slower Timed Up and Go speed that may be used to identify those at greater risk and in need of tailored falls prevention intervention.
OBJECTIVE: To identify risk factors for falling for people with Multiple Sclerosis. DESIGN: Prospective cohort study. SETTING: Neurology service in a tertiary hospital. SUBJECTS: Participants were 101 people with Multiple Sclerosis and Expanded Disability Status Score of 3-6.5. One participant withdrew after the baseline assessment; data were analysed for 100 participants. INTERVENTIONS: No intervention. MAIN MEASURES: Outcome was rate of falls, and predictors were Timed Up and Go, Symbol Digit Modalities test, demographics and 15 self-report questions about various symptoms including fatigue, concentration, dual tasking, bladder and bowel control. Three-month prospective diaries recorded falls. RESULTS: There were 791 falls reported over the 3-month period from a total of 56 fallers. Falls rate per person-year was 32.08 falls. Following multivariable regression analysis, the model with the greatest levels of clinical utility and discriminative ability (sensitivity 88% and area under the receiving operating curve statistic = 0.72, 95% CI 0.62-0.82), included the variables of history of a fall, not having visual problems, problems with bladder control and a slower speed on the Timed Up and Go. CONCLUSION: This study confirms the high incidence of falls for people with Multiple Sclerosis and provides a risk prediction model including fall history, problems with bladder control, not having visual problems and a slower Timed Up and Go speed that may be used to identify those at greater risk and in need of tailored falls prevention intervention.