History of fracture or sprain: New risk factors for falls in persons with multiple sclerosis

• Published in: Annals of physical and rehabilitation medicine Vol. 58; pp. e105 - e106
• Main Authors: Guyot, M.A, Grandjean, A., Dr, Khenioui, H., Dr, Hautecoeur, P., Prof, Donzé, C., Dr
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01-09-2015
• Subjects: Fall; Internal Medicine; Multiple sclerosis; Physical Medicine and Rehabilitation; Risk factor; Multiple sclerosis; Fall; Risk factor
• ISSN: 1877-0657; 1877-0665
• DOI: 10.1016/j.rehab.2015.07.256

Objective To study the risk factors for falls in patients with multiple sclerosis presenting gait disturbances. Methods This is a retrospective review of prospectively collected data from a cohort of MS patients followed for gait disturbances between April 2013 and June 2014 in the neurological rehabilitation department. The history of falls, trauma, current treatments and clinical data (disease duration, clinical form, EDSS, motor skills, spasticity, pain) were collected. Univariate and multivariate analyzes were performed to predict the risk of falls. Results One hundred and ninety-six patients (median EDSS: 6; age: 55 years [±9.3]) were divided into 2 groups: fallers ( n = 92), non-fallers ( n = 103). In our model, taking antidepressants, previous fractures (upper limbs, spine), sprains of ankles and knees, impaired visual and brain functions (or mental) of EDSS were predictors of falls (AUC = 0.73; sensitivity = 0.74; specificity = 0.59). Discussion Balance disorders and falls are among the most disabling symptoms of MS, affecting about 3/4 of patients during the course of the disease. In our study, 47.1% of patients had falled. These results are similar to those of Cattaneo et al. [1] , (54%) and of Finlayson et al. [2] , (52.2%). If visual disturbances and antidepressants have been identified as risk factors for falling, prior fracture and sprain were not included in those studies. This could explain the fear of falling in this population. Investigation of a history of fracture or sprain is recommended in the pervention of falls in MS patients with gait disturbances.