O'Malley Nicola, Clifford Amanda M, Comber Laura, Coote Susan
School of Allied Health, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland.
Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland.
Disabil Rehabil. 2022 Mar;44(6):856-864. doi: 10.1080/09638288.2020.1786173. Epub 2020 Jul 6.
To identify the definitions of a fall, faller classifications and outcomes used in prospectively-recorded falls research among people with Multiple Sclerosis (MS).
A systematic review of peer-reviewed journal articles was conducted using electronic databases. Relevant data were extracted by one reviewer and verified by a second independent reviewer.
Twenty-six papers met the inclusion criteria. A relative degree of heterogeneity existed amongst studies for the outcomes of interest to this review. Thirteen different fall definitions were identified. Fourteen different falls outcomes were used across the included studies, with six of these reported by only one study each. Data regarding injurious falls were presented by only eight papers. The majority ( = 17) of papers classified individuals as a faller if they fell at least once.
This review highlights the large variation in fall definitions, faller classifications and outcomes used in this research field. This hinders cross-comparison and pooling of data, thereby preventing researchers and clinicians from drawing conclusive findings from existing literature. The creation of an international standard for the definition of a fall, faller classification and falls outcomes would allow for transparent and coordinated falls research for people with MS, facilitating progression in this research field.Implications for rehabilitationFalls are a common occurrence among people with Multiple Sclerosis (MS) resulting in numerous negative consequences.There is large heterogeneity in the definitions, methods and outcomes used in falls research for people with MS.This lack of standardisation prevents the accurate cross-comparison and pooling of data, impeding the identification of falls risk factors and effective falls prevention interventions for people with MS.Consequently, clinicians should interpret the outcomes of falls research for people with MS with caution, particularly when comparing studies regarding falls risk assessments and falls prevention interventions for use in clinical practice.
确定在针对多发性硬化症（MS）患者的前瞻性记录跌倒研究中所使用的跌倒定义、跌倒者分类及结局。
使用电子数据库对同行评审的期刊文章进行系统综述。由一名评审员提取相关数据，并由另一名独立评审员进行核实。
26篇论文符合纳入标准。本综述所关注的结局在各研究中存在一定程度的异质性。共确定了13种不同的跌倒定义。纳入研究中使用了14种不同的跌倒结局，其中6种仅在一篇研究中被报告。仅有8篇论文呈现了关于跌倒致伤的数据。大多数（n = 17）论文将至少跌倒过一次的个体归类为跌倒者。
本综述凸显了该研究领域在跌倒定义、跌倒者分类及结局方面存在的巨大差异。这阻碍了数据的交叉比较和汇总，从而使研究人员和临床医生无法从现有文献中得出确凿结论。制定跌倒定义、跌倒者分类及跌倒结局的国际标准，将有助于为MS患者开展透明且协调一致的跌倒研究，推动该研究领域的发展。
对康复的启示
跌倒在多发性硬化症（MS）患者中很常见，会导致诸多负面后果。
在针对MS患者的跌倒研究中，所使用的定义、方法和结局存在很大异质性。
这种缺乏标准化的情况阻碍了数据的准确交叉比较和汇总，妨碍了对MS患者跌倒风险因素的识别以及有效的跌倒预防干预措施的确定。
因此，临床医生在解读针对MS患者的跌倒研究结果时应谨慎，尤其是在比较用于临床实践的跌倒风险评估和跌倒预防干预措施的研究时。
