Highlights
- •The FES-I cutoff score of 35.5 differentiates people with MS based on fall history.
- •FES-I was associated with quality of life, disability, functional mobility and dynamic balance in Iranian people with MS.
- •FES-I discriminates between different MS groups based on physical capacity.
Abstract
Background
The discriminative validity of fall efficacy scale international (FES-I) in differentiating
between fallers and non-fallers, levels of functional mobility, dynamic balance and
disability has not been assessed in Persian speaking people with multiple sclerosis
(MS).
Objective
To assess reliability, factor structure, construct and known group validity, sensitivity
and specificity of FES-I for differentiating individuals with and without a history
of fall and determining a cutoff point of the Persian version of the FES-I in people
with MS.
Method
One hundred thirty people with all subtypes of MS were included. The ability of FES-I
in differentiating fall history was assessed using receiver operating characteristic
(ROC). Also the FES-I score of groups based on expanded disability status scale (EDSS)
1-3.5 low and 4–6 moderate, time up and go (TUG) ≥14 sec and functional reach test
(FRT) ≥25 cm were compared. The correlation between FES-I with EDSS, TUG, FRT and
short form health survey (SF-36) was assessed.
Results
The ROC curve analysis revealed that the FES-I could differentiate people with MS
based on fall history at a cutoff score of 35.5. The area under the curve (AUC) was
0.86 (sensitivity 76%; specificity 95%). Significant difference was observed between
the FES-I score of groups with moderate and low EDSS scores (d = 2.98), higher than
14 sec TUG (d = 2.18) and lower than 25 cm FRT(d = 2.53). Significant high correlation
was observed between FES-I with TUG (r = 0.88), EDSS (r = 0.91), FRT (r = -0.83),
SF-36 physical (r = -0.87) and mental (r = -0.70) subscales.
Conclusions
The Persian versions of the FES-I could differentiate people with MS with fall history,
higher disability, lower functional mobility and balance deficiency.
Keywords
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Article info
Publication history
Published online: April 13, 2020
Accepted:
March 30,
2020
Received in revised form:
March 16,
2020
Received:
November 23,
2019
Footnotes
The study was performed at a referral center of Iranian multiple sclerosis society.
This research did not receive any specific grant or financial support.
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.
