Longitudinal evaluation of injurious falls and fall prevention strategy use among people with multiple sclerosis

Falls among people with multiple sclerosis (MS) are often injurious. We conducted a prospective cohort study using data collected at baseline, 12 months and 24 months to investigate the prevalence of self-reported injurious falls and trends in fall prevention strategy use among people with MS over this period. Fifty-eight community-dwelling people with MS between the ages of 18 and 50 years, with Expanded Disability Status Scale (EDSS) scores u003c 6.0, were recruited. Measures included self-reported injurious falls in the past year and scores on the Fall Prevention Strategies Survey (FPSS). A total of 43 subjects completed the study. Prevalence of self-reported injurious falls was 40%, 35%, and 16% respectively at each time point. Seventy-one percent of subjects reporting injurious falls at baseline (12/17) also reported injurious falls at 12 and/or 24 months. Subjects were divided into three subgroups for further analysis: subjects reporting injurious falls at baseline (N = 17); subjects reporting no injurious falls at baseline but subsequent injurious falls (N = 8), and subjects reporting no injurious falls over the 24-months (N = 18). That analysis revealed variations in injurious fall experiences and fall prevention strategy use by subgroup. FPSS scores for each subgroup improved at 24-months compared to baseline. Subgroup analyses yielded insights into sources of variation in injurious fall rates. Findings point to the potential value of using: a) self-reported history of injurious falls to predict future injurious falls; and b) brief interventions to motivate engagement in fall prevention behaviors. Additional studies are needed to test these hypotheses.