title: A simple test of choice stepping reaction time for assessing fall risk in people with multiple sclerosis.
abstract: Purpose To determine (a) the discriminant validity for established fall risk factors and (b) the predictive validity for falls of a simple test of choice stepping reaction time (CSRT) in people with multiple sclerosis (MS). Method People with MS (n = 210, 21-74y) performed the CSRT, sensorimotor, balance and neuropsychological tests in a single session. They were then followed up for falls using monthly fall diaries for 6 months. Results The CSRT test had excellent discriminant validity with respect to established fall risk factors. Frequent fallers (≥3 falls) performed significantly worse in the CSRT test than non-frequent fallers (0-2 falls). With the odds of suffering frequent falls increasing 69% with each SD increase in CSRT (OR = 1.69, 95% CI: 1.27-2.26, p = <0.001). In regression analysis, CSRT was best explained by sway, time to complete the 9-Hole Peg test, knee extension strength of the weaker leg, proprioception and the time to complete the Trails B test (multiple R2=0.449, p < 0.001). Conclusions A simple low tech CSRT test has excellent discriminative and predictive validity in relation to falls in people with MS. This test may prove useful in documenting longitudinal changes in fall risk in relation to MS disease progression and effects of interventions. Implications for rehabilitation Good choice stepping reaction time (CSRT) is required for maintaining balance. A simple low-tech CSRT test has excellent discriminative and predictive validity in relation to falls in people with MS. This test may prove useful documenting longitudinal changes in fall risk in relation to MS disease progression and effects of interventions.
authors.affiliation: a Neuroscience Research Australia , University of New South Wales , Sydney , Australia.|b Nijmegen Medical Centre , Radboud University Nijmegen , The Netherlands.
authors.forename: Mylou
authors.initials: M
authors.lastname: Tijsma
authors.affiliation: a Neuroscience Research Australia , University of New South Wales , Sydney , Australia.|b Nijmegen Medical Centre , Radboud University Nijmegen , The Netherlands.
authors.forename: Eva
authors.initials: E
authors.lastname: Vister
authors.affiliation: a Neuroscience Research Australia , University of New South Wales , Sydney , Australia.
authors.forename: Phu
authors.initials: P
authors.lastname: Hoang
authors.affiliation: a Neuroscience Research Australia , University of New South Wales , Sydney , Australia.
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Lord
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data*; D000328:Adult; D000368:Aged; D002755:Choice Behavior; D005260:Female; D006801:Humans; D057187:Independent Living; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology*; D009483:Neuropsychological Tests; D009517:New South Wales; D004856:Postural Balance / Q000502:physiology*; D011237:Predictive Value of Tests; D011930:Reaction Time; D012307:Risk Factors
keywords: Accidental falls; postural balance; risk factors; validation studies