Fear of Falling in People With Multiple Sclerosis: Which Clinical Characteristics Are Important?

Hanan Khalil, Alham Al-Shorman, Khalid El-Salem, Nour Abdo, Alia A Alghwiri, Aseel Aburub, Sarah Shalabi, Firas Al-Mustafa

Fear of falling (FOF) is an important risk indicator for health related outcomes and quality of life in patients with multiple sclerosis (MS). However, factors associated with FOF in MS are not well investigated. This study was done to explore predictors of FOF in this population. Seventy relapsing remitting patients with MS were evaluated. FOF was assessed using Fall Efficacy Scale-International (FES-I). Motor outcomes included: 30-second chair stand test (30s-CST), Berg Balance Scale, 10-Meter Walk Test (10-MWT) and 6-Minute Walk Test (6-MWT). Cognitive status was determined using Montréal Cognitive Assessment (MOCA) and Symbol Digit Modalities Test (SDMT). Affective factors including depression; fatigue and sleep were also assessed using Beck Depression Inventory (BDI), Modified Fatigue Impact Scale (MFIS), and Pittsburgh Sleep Quality Index (PSQI)respectively. FOF was significantly correlated with all motor and affective measures used. Howeve., a stepwise regression found that only BBS from motor measures, MOCA from cognitive measures, and sleep disorders from affective factors were significantly predictive of the FOF. FOF inpatients with MS is multifactorial and includes motor and non-motor factors. Thus, therapies that aim to reduce risk of falling in this population should address motor functions, cognitive abilities, and sleep quality.