Division of Physical Therapy, Department of Rehabilitation Medicine, University of Washington, Seattle, WA 98195, USA.
Phys Ther. 2012 Mar;92(3):407-15. doi: 10.2522/ptj.20100380. Epub 2011 Dec 1.
Falls in people with multiple sclerosis (MS) are a serious health concern, and the percentage of people who restrict their activity because of concerns about falling (CAF) is not known. Mobility function and accumulated impairments are associated with fall risk in older adults but not in people with stroke and have not been studied in people with MS.
The purposes of this study were: (1) to estimate the percentage of people who have MS and report falling, CAF, and activity restrictions related to CAF; (2) to examine associations of these factors with fall status; and (3) to explore associations of fall status with mobility function and number of accumulated impairments.
A cross-sectional survey was conducted.
A total of 575 community-dwelling people with MS provided information about sociodemographics, falls, CAF, activity restrictions related to CAF, mobility function, and accumulated impairments. Chi-square statistics were used to explore associations among these factors.
In all participants, about 62% reported CAF and about 67% reported activity restrictions related to CAF. In participants who did not experience falls, 25.9% reported CAF and 27.7% reported activity restrictions related to CAF. Mobility function was associated with fall status; participants reporting moderate mobility restrictions reported the highest percentage of falls, and participants who were nonwalkers (ie, had severely limited self-mobility) reported the lowest percentage. Falls were associated with accumulated impairments; the participants who reported the highest percentage of 2 or more falls were those with 10 impairments.
This cross-sectional study relied on self-reported falls, mobility, and impairment status, which were not objectively verified.
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.
多发性硬化症（MS）患者的跌倒问题是一个严重的健康隐患，目前尚不清楚因担心跌倒而限制活动的患者比例。在老年人中，移动功能和累积损伤与跌倒风险相关，但在中风患者中并非如此，在 MS 患者中也尚未进行研究。
本研究的目的是：（1）估计报告跌倒、担心跌倒和因担心跌倒而限制活动的 MS 患者比例；（2）检查这些因素与跌倒状态的关联；（3）探讨跌倒状态与移动功能和累积损伤数量的关联。
横断面调查。
共有 575 名居住在社区的 MS 患者提供了社会人口统计学、跌倒、担心跌倒、因担心跌倒而限制活动、移动功能和累积损伤等信息。使用卡方检验来探索这些因素之间的关联。
在所有参与者中，约 62%报告有担心跌倒，约 67%报告因担心跌倒而限制活动。在未经历跌倒的参与者中，25.9%报告有担心跌倒，27.7%报告因担心跌倒而限制活动。移动功能与跌倒状态相关；报告中度移动受限的参与者跌倒比例最高，无法行走（即自我移动能力严重受限）的参与者跌倒比例最低。跌倒与累积损伤相关；报告 2 次或更多跌倒的参与者累积损伤最多。
本横断面研究依赖于自我报告的跌倒、移动和损伤状况，这些状况未经客观验证。
担心跌倒和因担心跌倒而限制活动在 MS 患者中很常见，既发生在跌倒患者中，也发生在未跌倒患者中。跌倒状态与移动功能之间的关联似乎不是线性的。随着移动功能的下降，跌倒风险增加；然而，在一定的阈值下，移动功能的进一步下降与较少的跌倒相关，这可能是由于跌倒风险暴露减少。
