Falls in People with Multiple Sclerosis

Abstract

Falls are highly prevalent for people with Multiple Sclerosis (MS) and result in a range of negative consequences such as injury, activity curtailment, reduced quality of life, increased need for care and time off work. This narrative review aims to summarise key literature and to discuss future work needed in the area of falls prevention for people with MS. The incidence of falls is estimated to be over 50%; similar to the rate of falls in adults over 80 years. The consequences of falls are considerable as rate of injury is high, and fear of falling and low self-efficacy are significant problems that lead to activity curtailment. A wide range of physiological, personal and environmental factors have been highlighted as potential risk factors and predictors of falls. Falls are individual and multifactorial, and hence approaches to interventions will likely need to adopt a multi-factorial approach. However, the literature to date has largely focused on exercise-based interventions, with newer more comprehensive interventions using both education and exercise showing promising results. Several gaps remain in the topic of falls in MS and in particular the lack of standardisation of definitions and outcome measures to enable data pooling and comparison. In future, the involvement of people with MS in the design and evaluation of programmes is essential, as are approaches to intervention development that consider implementation from the outset.

A Preliminary Investigation of the Effects of Obstacle Negotiation and Turning on Gait Variability in Adults with Multiple Sclerosis

“…Consequentially, approximately 75–90% of PwMS experience mobility issues [ 3 ] and PwMS fall at a higher rate and more often than those aging without neurologic impairment [ 4 ]. Over half of PwMS fall in any 6-month period [ 5 ], with many experiencing repeated falls and falls-related injury [ 6 ]. Falls can intensify already existing fear of falling [ 7 ], decrease physical activity [ 6 ], and reduce quality of life [ 8 ].…”

“…Over half of PwMS fall in any 6-month period [ 5 ], with many experiencing repeated falls and falls-related injury [ 6 ]. Falls can intensify already existing fear of falling [ 7 ], decrease physical activity [ 6 ], and reduce quality of life [ 8 ].…”

Cranial Nerve Noninvasive Neuromodulation in Adults With Neurological Conditions: Protocol for a Scoping Review

“…Recent literature has explored the burden of disability among patients with neurological conditions [ 4 - 6 ]. Older adults living with neurological disorders are at a significantly higher risk of falls compared to healthy older adults [ 4 ].…”

“…Additionally, motor function deficits make common activities challenging for stroke survivors, such as reaching, grasping, and holding onto household objects [ 5 ]. Similar functional impairments have been observed in people with MS. Coote et al [ 6 ] reported that over a 6-month period, 71% of older adults with MS sustained a fall compared to 41% of age-matched healthy controls. Individuals with MS who experienced a fall were much more likely to sustain serious injury [ 6 ].…”

“…Similar functional impairments have been observed in people with MS. Coote et al [ 6 ] reported that over a 6-month period, 71% of older adults with MS sustained a fall compared to 41% of age-matched healthy controls. Individuals with MS who experienced a fall were much more likely to sustain serious injury [ 6 ]. As the neurological burden of disease is expected to grow over the coming decades, the development of new, effective rehabilitation interventions to improve the lives of people with neurological conditions is of utmost importance [ 1 ].…”