title: Risk factors for falls in multiple sclerosis: an observational study.
abstract: BACKGROUND
  People with multiple sclerosis (MS) experience frequent falls, which are associated with impairments and limitations to activities and participations.
  
  
  OBJECTIVE
  The objective of this paper is to evaluate falls risk factors using robust clinical measures.
  
  
  METHODS
  A total of 150 individuals (confirmed MS diagnosis, Expanded Disability Status Scale (EDSS) 3.5-6.5) were recruited, with 148 participants included in the final analysis. Demographic data were collected and performance assessed in eight predictor measures (Physiological Profile Assessment (PPA), Brief Ataxia Rating scale, Ashworth scale (Ashworth), Modified Falls Efficacy scale, Symbol Digit Modalities Test, dual-task interference, lying/standing blood pressure, static/dynamic visual acuity). Participants prospectively recorded falls over three months using a daily diary. People were classified as "fallers" based on reports of ≥ two falls.
  
  
  RESULTS
  A total of 104 participants recorded 672 falls; 78 (52.7%) reported ≥ two falls. Continence issues, previous falls history and use of prescribed medications were each associated with increased risk of being a "faller". Ashworth and PPA risk score contributed significantly to a logistic regression model predicting faller/non-faller classification. The reduced model (Ashworth, PPA, EDSS) showed fair-to-good predictive ability (ROC c-statistic 0.73, sensitivity 70%, specificity 69%).
  
  
  CONCLUSIONS
  This study confirms the high prevalence of falls in ambulant people with MS. Important potentially modifiable risk factors are identified, suggesting aspects to target in falls interventions.
authors: School of Health Professions, Plymouth University, UK.
authors: Hilary
authors: H
authors: Gunn
authors: Siobhan
authors: S
authors: Creanor
authors: Bernhard
authors: B
authors: Haas
authors: Jonathan
authors: J
authors: Marsden
authors: Jennifer
authors: J
authors: Freeman
mesh_terms: D000058:Accidental Falls; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
keywords: Multiple sclerosis; accidental falls; rehabilitation; risk factors