Archives of physical medicine and rehabilitation · 2025
Association of Self-Reported Dual-Task Ability With Fear of Falling and Recurrent Falls in Individuals With Multiple Sclerosis.
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Bae Myeongjin, Kasser Susan L, VanNostrand Michael
Аннотация
OBJECTIVE: To determine the association of self-reported dual-task ability with fear of falling and recurrent falls in individuals with multiple sclerosis (MS).
DESIGN: Cross-sectional study.
SETTING: Individuals with MS were recruited from the general community in the US.
PARTICIPANTS: A total of 1083 people (N=1083) with MS were enrolled. The sample was predominantly women (80.52%). Of the total, 262 participants (24.19%) were classified as recurrent fallers. Patient Determined Disease Steps scores ranged from 0 to 6, with 563 participants (52.00%) reporting mild disability (Patient Determined Disease Steps=0-2).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: A Dual-Task Impact on Daily Life Activities Questionnaire (DIDA-Q) and its subdomains of motor-motor interference (MMI) and cognitive-motor interference (CMI) were assessed. The total, MMI, and CMI scores were expressed in a 5-point interval scale for ease of interpretation. The total score of the Fall Efficacy Scale-International was dichotomized into low and high fear of falling based on a cutoff score of 35.5. Fall status was categorized as nonfall or single fall (≤1 fall) and recurrent falls (>1 fall) within the past 3 months.
RESULTS: Every 5-point increase in the DIDA-Q was significantly associated with fear of falling (odds ratio [OR], 1.71; 95% CI, 1.56-2.88), as were the CMI (OR, 2.05; 95% CI, 1.80-2.34) and MMI (OR, 3.48; 95% CI, 2.80-4.34). The DIDA-Q total score (OR, 1.14; 95% CI, 1.07-1.21), CMI (OR, 1.19; 95% CI, 1.09-1.29), and MMI (OR, 1.42; 95% CI, 1.21-1.66) were significantly associated with increased likelihood of recurrent falls.
CONCLUSIONS: The study indicates that self-reported dual-task difficulty was associated with fear of falling and recurrent falls in persons with MS. Considering that current in-lab dual-task assessments are insufficient to predict falls, the self-reported dual-task questionnaire can be an effective alternative for screening fall risk in this population.
DESIGN: Cross-sectional study.
SETTING: Individuals with MS were recruited from the general community in the US.
PARTICIPANTS: A total of 1083 people (N=1083) with MS were enrolled. The sample was predominantly women (80.52%). Of the total, 262 participants (24.19%) were classified as recurrent fallers. Patient Determined Disease Steps scores ranged from 0 to 6, with 563 participants (52.00%) reporting mild disability (Patient Determined Disease Steps=0-2).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: A Dual-Task Impact on Daily Life Activities Questionnaire (DIDA-Q) and its subdomains of motor-motor interference (MMI) and cognitive-motor interference (CMI) were assessed. The total, MMI, and CMI scores were expressed in a 5-point interval scale for ease of interpretation. The total score of the Fall Efficacy Scale-International was dichotomized into low and high fear of falling based on a cutoff score of 35.5. Fall status was categorized as nonfall or single fall (≤1 fall) and recurrent falls (>1 fall) within the past 3 months.
RESULTS: Every 5-point increase in the DIDA-Q was significantly associated with fear of falling (odds ratio [OR], 1.71; 95% CI, 1.56-2.88), as were the CMI (OR, 2.05; 95% CI, 1.80-2.34) and MMI (OR, 3.48; 95% CI, 2.80-4.34). The DIDA-Q total score (OR, 1.14; 95% CI, 1.07-1.21), CMI (OR, 1.19; 95% CI, 1.09-1.29), and MMI (OR, 1.42; 95% CI, 1.21-1.66) were significantly associated with increased likelihood of recurrent falls.
CONCLUSIONS: The study indicates that self-reported dual-task difficulty was associated with fear of falling and recurrent falls in persons with MS. Considering that current in-lab dual-task assessments are insufficient to predict falls, the self-reported dual-task questionnaire can be an effective alternative for screening fall risk in this population.