title: Falls in people with multiple sclerosis who use a walking aid: prevalence, factors, and effect of strength and balance interventions.
abstract: OBJECTIVE
  To investigate falls prevalence, factors associated with falling, and the effects of balance and strengthening interventions on falls in persons with multiple sclerosis (MS).
  
  
  METHODS
  Baseline and posttreatment data from a randomized controlled trial.
  
  
  METHODS
  Community.
  
  
  METHODS
  People with MS (N=111) who use bilateral support for gait.
  
  
  METHODS
  Group and one-on-one physiotherapy.
  
  
  METHODS
  Falls prevalence was assessed using retrospective recall. Demographic information was collected, impairments of body function were assessed, and results from the Berg Balance Scale, 6-minute walk test (6MWT), Multiple Sclerosis Impact Scale-29 version 2 physical and psychological scores, and the Modified Fatigue Impact Scale (MFIS) were obtained.
  
  
  RESULTS
  The prevalence of falls in a 3-month period was 50.5% among participants with MS, of whom 28% had more than 1 fall. Fallers had a greater physical (mean difference, -3.9; P=.048) and psychological (median difference, -4.5; P=.001) impact of MS and a greater impact of fatigue (mean difference, -9.4; P=.002). A logistic regression analysis found that the MFIS score made a unique, significant contribution to the model (odds ratio=1.04; 95% confidence interval, 1.018-1.079), correctly identifying 68% of fallers. A 10-week group physiotherapy intervention significantly reduced both the number of fallers (58.3% before to 22.9% after intervention, P=.005) and the number of falls (63 before to 25 after intervention, P=.001).
  
  
  CONCLUSIONS
  The prevalence of falls is high in this population of persons with MS, and the impact of MS and of fatigue is greater in fallers. Development and evaluation of interventions to reduce falls risk and the transition to faller or multiple faller status are required.
authors.affiliation: Department of Clinical Therapies & Centre for Physical Activity and Health Research, University of Limerick, Limerick, Ireland. susan.coote@ul.ie
authors.forename: Susan
authors.initials: S
authors.lastname: Coote
authors.forename: Neasa
authors.initials: N
authors.lastname: Hogan
authors.forename: Sue
authors.initials: S
authors.lastname: Franklin
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control* / Q000706:statistics & numerical data; D000368:Aged; D015331:Cohort Studies; D051341:Dependent Ambulation; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D053580:Muscle Strength / Q000502:physiology; D009983:Orthopedic Equipment; D004856:Postural Balance / Q000502:physiology; D015995:Prevalence; D012307:Risk Factors; D012656:Self-Help Devices; D015013:Yoga