Article

OBJECTIVES: To determine whether impaired performance in a range of vision,
proprioception, neuropsychological, balance, and mobility tests and pain and
fatigue are associated with falls in people with multiple sclerosis (PwMS).
DESIGN: Prospective cohort study with 6-month follow-up.
SETTING: A multiple
sclerosis (MS) physiotherapy clinic. PARTICIPANTS: Community-dwelling people
(N=210; age range, 21-74y) with MS (Disease Steps 0-5). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Incidence of falls during 6 months' follow-up.
RESULTS: In the 6-month follow-up period, 83 participants (39.7%) experienced no
falls, 57 (27.3%) fell once or twice, and 69 (33.0%) fell 3 or more times.
Frequent falling (>/=3) was associated with increased postural sway (eyes open
and closed), poor leaning balance (as assessed with the coordinated stability
task), slow choice stepping reaction time, reduced walking speed, reduced
executive functioning (as assessed with the difference between Trail Making Test
Part B and Trail Making Test Part A), reduced fine motor control (performance on
the 9-Hole Peg Test [9-HPT]), and reported leg pain. Increased sway with the eyes
closed, poor coordinated stability, and reduced performance in the 9-HPT were
identified as variables that significantly and independently discriminated
between frequent fallers and nonfrequent fallers (model chi(2)3=30.1, P<.001).
The area under the receiver operating characteristic curve for this model was
.712 (95% confidence interval, .638-.785). CONCLUSIONS: The study reveals
important balance, coordination, and cognitive determinants of falls in PwMS.
These should assist the development of effective strategies for prevention of
falls in this high-risk group.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS