Article

OBJECTIVE: To identify measures of balance, gait, and strength that predict falls
in women with multiple sclerosis (MS). This prospective study followed
participants for 1 year. SETTING: University research laboratories. PARTICIPANTS:
A convenience sample of women with MS (N=99). INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: Balance was assessed with the limits of stability (LOS) test
and the Sensory Organization Test. Peak force, torque, and power of knee flexors
and extensors as well as hip abductors and adductors were also measured.
Temporal-spatial parameters of gait were measured by an instrumented walkway
system. For 1 year after baseline assessments, the participants reported their
falls. Participants were then classified based on the number of reported falls
for use in logistic regression models to predict either people with at least 1 fall or people with at least 2 falls (recurrent fallers). RESULTS: A total of 159
falls were reported by 48% of the participants. Expanded Disability Status Scale
scores, leaning forward to the LOS, and standing sway within a visually
referenced surround significantly predicted people with at least 1 fall as well
as recurrent fallers. Stance-phase asymmetries and base-of-support width during
gait, as well as the force and power produced during leg extension or flexion
additionally predicted recurrent fallers. The models' overall predictive accuracy
ranged from 69% to 85%. CONCLUSIONS: This prospective study confirmed the
prevalence and multifactorial nature of falls in this MS sample. In addition to
advancing disease status, impaired forward LOS and visually dependent sway (as
well as gait asymmetries and leg flexor-extensor weakness for recurrent fallers)
predict future falls in women with MS.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS