Gopal Arpita, Gelfand Jeffrey M, Bove Riley, Block Valerie J
UCSF Weill Institute for Neurosciences (AG, JMG, RB), MS and Neuroinflammation Clinic, Department of Neurology; and Department of Physical Therapy and Rehabilitation Science (VJB), University of California, San Francisco.
Neurol Clin Pract. 2023 Oct;13(5):e200184. doi: 10.1212/CPJ.0000000000200184. Epub 2023 Sep 14.
Falls occur in more than half of all people with multiple sclerosis (MS) but tend to be underdiagnosed and underreported in clinical encounters. This narrative review aims to summarize evidence-based approaches for evaluating fall risk and proven treatment strategies to reduce falling in people with MS to improve care for people with MS and to enhance interprofessional care coordination between treating neurologic and physical therapy (PT) teams.
Screening not just for but for as well because can improve fall assessment and identify patients who may benefit from fall prevention interventions. A number of barriers, including time constraints during visits and the fallacy that falling is inevitable in MS, can limit clinician awareness about patient falls and delay timely referral to PT. Consultation with physical therapists for individualized fall prevention treatment can reduce risk of falling. Interventional studies have also shown that PT-guided exercise programs improve balance confidence in people with MS. However, people with MS are often under-referred to PT by treating clinicians.
A clinical approach is provided to summarize practical, accessible, evidence-based, low-burden measurements and interventions likely to improve ascertainment of patients at risk of falling and optimize timely PT referral and treatment.
超过半数的多发性硬化症（MS）患者会发生跌倒，但在临床诊疗中往往诊断不足且报告较少。本叙述性综述旨在总结基于证据的跌倒风险评估方法以及经证实的降低MS患者跌倒风险的治疗策略，以改善对MS患者的护理，并加强神经内科治疗团队与物理治疗（PT）团队之间的跨专业护理协调。
不仅要筛查[此处原文缺失部分内容]，还要筛查[此处原文缺失部分内容]，因为[此处原文缺失部分内容]可以改善跌倒评估，并识别可能从预防跌倒干预措施中受益的患者。包括就诊时的时间限制以及认为MS患者跌倒不可避免的错误观念在内的一些障碍，可能会限制临床医生对患者跌倒情况的认知，并延迟及时转诊至PT科。与物理治疗师协商进行个性化的预防跌倒治疗可以降低跌倒风险。干预性研究还表明，PT指导的运动计划可提高MS患者的平衡信心。然而，MS患者往往较少被临床治疗医生转诊至PT科。
提供了一种临床方法，以总结实用、可行、基于证据且负担较小的测量方法和干预措施，这些措施可能会改善对有跌倒风险患者的诊断，并优化及时转诊至PT科及进行治疗。
