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CURRENT ISSUEEUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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ORIGINAL ARTICLES  


European Journal of Physical and Rehabilitation Medicine 2015 April;51(2):197-205

language: English

Concern about falling is associated with step length in persons with multiple sclerosis

Kalron A. 1, 2, Frid L. 2, Gurevich M. 2

1 Physical Therapy Department, Sackler Faculty of Medicine, Tel-Aviv University, Israel;
2 Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel


FULL TEXT  REPRINTS


BACKGROUND: Fear of falling is one of the major concerns of people with multiple sclerosis (MS). Although, it is likely that associations between spatio-temporal gait parameters and fear of falling exist in the MS population, these relationships have never been extensively studied.
AIM: Aim of the study was to determine if fear of falling is associated with spatio-temporal gait parameters in persons with MS.
DESIGN: Cross sectional study with a control group.
SETTINGS: Multiple Sclerosis Center, Sheba Medical Center, Tel-Hashomer, Israel.
METHODS: One-hundred and thirty relapsing-remitting patients diagnosed with MS, 79 women and 51 men aged 42.6 (SD=11.9), participated in this investigation. Twenty-five healthy subjects, 14 women and 11 men aged 38.5 (SD= 12.3), served as controls. Spatio-temporal parameters of gait were studied using the GAITRiteTM system (CIR Systems Inc., NJ, USA); Falls Efficacy Scale International (FES-I) was used to assess the level of concern relating to falls. Participants who scored >20 were classified as more concerned (N.=83), while those scoring ≤20 were defined as less concerned (N.=47).
RESULTS: More concerned participants walked slower, took smaller steps, prolonged double support phase, wider base of support and a shorter single support phase compared to the less concerned group. According to step one of the multiple linear regression model, the spatial gait component accounted for 30.9% of the variance related to fear of falls (F=56.3, P<0.001). Step two added the gait temporal component, thus increasing the variance to 36.7% (F=36.2, P<0.001). Step three added the gait asymmetry parameters, thus increasing the predictor model to account for 40.3% of the variance in fear of falling (F=29.6, P<0.001).
CONCLUSION: The present study provides quantitative evidence establishing spatio-temporal gait performance in individuals with MS relative to the level of fear of falling.
CLINICAL REHABILITATION IMPACT: Spatio-temporal gait parameters may aid in assessing the level of fear of falling in people with MS. Step length may also serve as a surrogate outcome for assessing outcomes of interventions aimed at reducing fear of falling in the MS population.

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