Highlights
- •Mobility and cognitive impairments associated with multiple sclerosis seriously impact fall risk.
- •Assessing if individuals with MS have difficulties dual tasking enhances fall risk prediction.
- •Accurate prediction of fall risk based on self-reported difficulty of dual tasking is beneficial for early identification and timely intervention for adults with MS.
Abstract
Background
Mobility challenges and cognitive impairments prominent in adults with multiple sclerosis
(MS) significantly increase the risk of falling. Examining perceptions of how the
simultaneous performance of completing motor and cognitive tasks impacts fall risk
may have clinical utility. The purpose of this study was to identify the most significant
self-reported predictors of falling including perceived dual-tasking.
Methods
Participants included 79 individuals with MS were surveyed and reported their fall
history over the previous 3 months and completed the Multiple Sclerosis Walking Scale
-12 (MSWS-12), Modified Fatigue Impact Scale (MFIS), Falls Efficacy Scale International
(FES-I), and two Dual-Task Questionnaires (DTQ), a previously published original one
and a newly expanded version.
Results
Of the sample, 63 were classified as non-fallers and 16 as fallers. Backward stepwise
regression analysis revealed that perceived ambulation disability and dual-tasking
best predicted fall status (sensitivity of 57.7%, specificity of 90.6%, area under
the receiving operating curve of 0.81 (95% CI 0.70–0.92).
Conclusion
The inclusion of self-reported dual-tasking perceptions has utility in predicting
fall risk. Effective assessment toward this end offers the potential for early detection
and intervention.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Multiple Sclerosis and Related DisordersAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Identifying falls remotely in people with multiple sclerosis.J. Neurol. 2021;
- Objective and subjective measures reflect different aspects of balance in multiple sclerosis.J. Rehabil. Res. Dev. 2013; 50: 1401-1410
- Balance, gait, and falls in multiple sclerosis.Handb. Clin. Neurol. 2018; 159: 237-250
- Predicting fallsin people with multiple sclerosis: falls history is as accurate as more complex measures.Mult. Scler. Int. 2013; 496395
- Falls in people with multiple sclerosis: experiences of 115 fall situations.Clin. Rehabil. 2018; 32: 526-535
- Cognitive impairment in multiple sclerosis.Lancet Neurol. 2008; 7: 1139-1151
- Falls in people with multiple sclerosis: risk identification, intervention, and future directions.Int. J. MS Care. 2020; 22: 247-255
- Fall incidence as the primary outcome in multiple sclerosis falls-prevention trials: recommendation from the International MS Falls Prevention Research Network.Int. J. MS Care. 2014; 16: 178-184
- Utility of disease-specific measures and clinical balance tests in prediction of falls in persons with multiple sclerosis.J. Neurol. Phys. Ther. 2013; 37: 99-104
- Dual task cost of cognition is related to fall risk in patients with multiple sclerosis: a prospective study.Clin. Rehabil. 2017; 31: 278-284
- Walking and talking therapy: improving cognitive-motor dual-tasking in neurological illness.J. Int. Neuropsychol. Soc. 2009; 15: 112-120
- Distinguishing among multiple sclerosis fallers, near-fallers and non-fallers.Mult. Scler. Relat. Disord. 2018; 19: 99-104
- Measuring the impact of MS on walking ability: the 12-Item MS Walking Scale (MSWS-12.Neurology. 2003; 60: 31-36
- Disease steps in multiple sclerosis: a simple approach to evaluate disease progression.Neurology. 1995; 45: 251-255
- The relationship between fear of falling to spatiotemporal gait parameters measured by an instrumented treadmill in people with multiple sclerosis.Gait Posture. 2014; 39: 739-744
- Fear of falling, not falls, impacts leisure-time physical activity in people with multiple sclerosis.Gait Posture. 2018; 65: 33-38
- Evaluation of the modified fatigue impact scale in four different European countries.Mult. Scler. 2005; 11: 76-80
- Fear of falling Is associated with recurrent falls in people with multiple sclerosis: a longitudinal cohort study.Int. J. MS Care. 2015; 17: 164-170
- Confirming the validity and responsiveness of the multiple sclerosis walking scale-12 (MSWS-12.Neurology. 2004; 62: 2103-2105
- Falls in people with MS–an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States'.Mult. Scler. 2015; 21: 92-100
- ‘Fall definitions, faller classifications and outcomes used in falls research among people with multiple sclerossi: a systematic review.Dis. Rehabil. 2022; 44: 855-863
- The patients' perspective on the perceived difficulties of dual-tasking: development and validation of the dual-task impact on daily-living activities questionnaire (DIDA-Q).Mult. Scler. Relat. Disord. 2020; 46102601
- Discriminative ability and clinical utility of the timed up and go (TUG) in identifying falls risk in people with multiple sclerosis: a prospective cohort study.Clin. Rehabil. 2019; 33: 317-326
- An exploration of falls and dual tasking: a prospective cohort study of people with multiple sclerosis.Top Geriatr. Rehabil. 2019; 35: 190-198
- Measuring fatigue in patients with multiple sclerosis: reproducibility, responsiveness and concurrent validity of three Dutch self-report questionnaires.Disabil. Rehabil. 2010; 32: 1870-1876
- Predicting falls among patients with multiple sclerosis: comparison of patient-reported outcomes and performance-based measures of lower extremity functions.Mult. Scler. Relat. Disord. 2017; 17: 69-74
- Falls efficacy scale-international: a cross-sectional validation in people with multiple sclerosis.Arch. Phys. Med. Rehabil. 2013; 94: 883-889
- Structured cognitive-motor dual task training compared to single mobility training in persons with multiple sclerosis, a multicenter RCT.J. Clinl. Med. 2019; 8: 2177
- Dual task cost of walking is related to fall risk in persons with multiple sclerosis.J. Neurol. Sci. 2013; 335: 160-163
- Development and initial validation of the falls efficacy scale-international (FES-I).Age Ageing. 2005; 34: 614-619
Article info
Publication history
Published online: August 14, 2022
Accepted:
August 13,
2022
Received in revised form:
July 15,
2022
Received:
March 26,
2022
Identification
Copyright
© 2022 Elsevier B.V. All rights reserved.
