Identifying falls remotely in people with multiple sclerosis.
Fall
Falling
Multiple sclerosis
Outcome measurement
Quality improvement
Remote monitoring
Journal
Journal of neurology
ISSN: 1432-1459
Titre abrégé: J Neurol
Pays: Germany
ID NLM: 0423161
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
26
04
2021
accepted:
03
08
2021
revised:
27
07
2021
pubmed:
19
8
2021
medline:
25
3
2022
entrez:
18
8
2021
Statut:
ppublish
Résumé
Falling is common in people with multiple sclerosis (MS) but tends to be under-ascertained and under-treated. To evaluate fall risk in people with MS. Ninety-four people with MS, able to walk > 2 min with or without an assistive device (Expanded Disability Status Scale (EDSS ≤ 6.5) were recruited. Clinic-based measures were recorded at baseline and 1 year. Patient-reported outcomes (PROs), including a fall survey and the MS Walking Scale (MSWS-12), were completed at baseline, 1.5, 3, 6, 9, and 12 months. Average daily step counts (STEPS) were recorded using a wrist-worn accelerometer. 50/94 participants (53.2%) reported falling at least once. Only 56% of participants who reported a fall on research questionnaires had medical-record documented falls. Fallers had greater disability [median EDSS 5.5 (IQR 4.0-6.0) versus 2.5 (IQR 1.5-4.0), p < 0.001], were more likely to have progressive MS (p = 0.003), and took fewer STEPS (mean difference - 1,979, p = 0.007) than Non-Fallers. Stepwise regression revealed MSWS-12 as a major predictor of future falls. Falling is common in people with MS, under-reported, and under-ascertained by neurologists in clinic. Multimodal fall screening in clinic and remotely may help improve patient care by identifying those at greatest risk, allowing for timely intervention and referral to specialized physical rehabilitation.
Sections du résumé
BACKGROUND
BACKGROUND
Falling is common in people with multiple sclerosis (MS) but tends to be under-ascertained and under-treated.
OBJECTIVE
OBJECTIVE
To evaluate fall risk in people with MS.
METHODS
METHODS
Ninety-four people with MS, able to walk > 2 min with or without an assistive device (Expanded Disability Status Scale (EDSS ≤ 6.5) were recruited. Clinic-based measures were recorded at baseline and 1 year. Patient-reported outcomes (PROs), including a fall survey and the MS Walking Scale (MSWS-12), were completed at baseline, 1.5, 3, 6, 9, and 12 months. Average daily step counts (STEPS) were recorded using a wrist-worn accelerometer.
RESULTS
RESULTS
50/94 participants (53.2%) reported falling at least once. Only 56% of participants who reported a fall on research questionnaires had medical-record documented falls. Fallers had greater disability [median EDSS 5.5 (IQR 4.0-6.0) versus 2.5 (IQR 1.5-4.0), p < 0.001], were more likely to have progressive MS (p = 0.003), and took fewer STEPS (mean difference - 1,979, p = 0.007) than Non-Fallers. Stepwise regression revealed MSWS-12 as a major predictor of future falls.
CONCLUSIONS
CONCLUSIONS
Falling is common in people with MS, under-reported, and under-ascertained by neurologists in clinic. Multimodal fall screening in clinic and remotely may help improve patient care by identifying those at greatest risk, allowing for timely intervention and referral to specialized physical rehabilitation.
Identifiants
pubmed: 34405267
doi: 10.1007/s00415-021-10743-y
pii: 10.1007/s00415-021-10743-y
pmc: PMC8370664
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1889-1898Subventions
Organisme : NCATS NIH HHS
ID : KL2 TR000143
Pays : United States
Organisme : NINDS NIH HHS
ID : R35 NS111644
Pays : United States
Organisme : NCATS NIH HHS
ID : KL2TR000143
Pays : United States
Informations de copyright
© 2021. The Author(s).
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