Factors associated with falls in persons with MS are similar to those in other populations with neurologic diseases. Despite the high incidence of falls, fewer than 50% of people with MS receive information about prevention of falls from an HCP.

Both CAF and activity restrictions related to CAF were common in people with MS and were reported by people who experienced falls and those who did not. The association of fall status with mobility function did not appear to be linear. Fall risk increased with declining mobility function; however, at a certain threshold, further declines in mobility function were associated with fewer falls, possibly because of reduced fall risk exposure.

While individual factors were associated with level of participation, results failed to accurately predict participation in community ambulation following stroke. Other factors, such as depression, cognition and self-efficacy may be stronger determinants of participation.

Avoidance of features within some, but not all, environmental dimensions was associated with self-reported frequency of community walking following stroke, suggesting that some environmental features may limit community walking more than others.

No abstract

The mDGI, with its expanded scoring system, improves the range, discrimination, and facets of measurement related to walking function. The strength of the psychometric properties of the mDGI warrants its adoption for both clinical and research purposes.

The strength of the psychometric properties of the mDGI across the 5 diagnostic groups further supports the validity and usefulness of scores for clinical and research purposes. In addition, the meaning of a score from the mDGI, regardless of whether at the task, performance facet, or total score level, was comparable across the 5 diagnostic groups, suggesting that the mDGI measured mobility function independent of medical diagnosis.

Support for the environmental framework underlying the mDGI extends its usefulness as a clinical measure of functional mobility by providing a rationale for interpretation of scores that can be used to direct treatment and infer change in mobility function.