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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


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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