Abasıyanık Zuhal, Kahraman Turhan, Ertekin Özge, Baba Cavid, Özakbaş Serkan
Graduate School of Health Sciences, Dokuz Eylül University, Izmir, Turkey; Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Izmir Katip Celebi University, Izmir, Turkey.
Mult Scler Relat Disord. 2021 Apr;49:102771. doi: 10.1016/j.msard.2021.102771. Epub 2021 Jan 18.
Falls are common in persons with Multiple Sclerosis (pwMS) and lead to destructive results, specifically with increasing disability. However, there is only scarce data investigating prevalence and determinants of falls in pwMS without a clinical disability. Therefore, this study aimed to investigate proportion of fallers and related factors in pwMS without a clinical disability.
One hundred and four pwMS with no clinical disability (EDSS≤1.5) were recruited in this cross-sectional study. The outcome measures comprised of the Timed 25-Foot Walk (T25FW), Six Minute Walk Test (6MWT), Timed Up and Go Test (TUG), Multiple Sclerosis Walking Scale (MSWS-12), Single Leg Stance Test (SLS), Activities-Specific Balance Confidence Scale (ABC), Symbol Digit Modalities Test (SDMT), Modified Fatigue Impact Scale (MFIS), and Beck Depression Inventory-II (BDI-II). The number of falls during the last three months was recorded.
Twenty-five percent of the pwMS reported at least one fall in the last three months. The TUG and MSWS-12 scores were significantly greater in the fallers compared to non-fallers (p<0.05). Whereas the fallers had significantly less ABC scores (p<0.05). Increasing TUG and MSWS-12 score and decreasing ABC score was related with increased risk of being classified as a faller adjusting for EDSS score.
The present findings highlight that falls are frequent problem for pwMS, even if they do not have a clinical disability. Therefore, falls prevention strategies are also required in the early stages of the disease in clinical practice. The ABC scale, MSWS-12, and TUG test can be used by the clinicians and researchers to predict potential fallers of the pwMS without a clinical disability.
跌倒在多发性硬化症患者（pwMS）中很常见，并会导致破坏性后果，尤其是随着残疾程度的增加。然而，关于无临床残疾的pwMS患者跌倒的患病率和决定因素的研究数据很少。因此，本研究旨在调查无临床残疾的pwMS患者中跌倒者的比例及相关因素。
在这项横断面研究中招募了104名无临床残疾（扩展残疾状态量表[EDSS]≤1.5）的pwMS患者。结局指标包括25英尺步行时间测试（T25FW）、6分钟步行试验（6MWT）、起立行走测试（TUG）、多发性硬化症步行量表（MSWS-12）、单腿站立试验（SLS）、特定活动平衡信心量表（ABC）、符号数字模态测试（SDMT）、改良疲劳影响量表（MFIS）和贝克抑郁量表第二版（BDI-II）。记录过去三个月内的跌倒次数。
25%的pwMS患者报告在过去三个月中至少跌倒过一次。与未跌倒者相比，跌倒者的TUG和MSWS-12评分显著更高（p<0.05）。而跌倒者的ABC评分显著更低（p<0.05）。调整EDSS评分后，TUG和MSWS-12评分增加以及ABC评分降低与被归类为跌倒者的风险增加有关。
目前的研究结果强调，即使没有临床残疾，跌倒也是pwMS患者常见的问题。因此，在临床实践中疾病早期也需要采取预防跌倒的策略。临床医生和研究人员可以使用ABC量表、MSWS-12和TUG测试来预测无临床残疾的pwMS患者中可能跌倒的人。
