Causes, Context and Consequences of Falls

Falls prevention interventions are a growing area of research in MS. However, in order to develop more effective falls prevention interventions, more information is needed on the exact causes, context and consequences of falls in MS. Therefore, the MS research team in UL conducted a study to determine the frequency and consequences of falls from three months of prospective falls diaries in an MS cohort.

What was involved?

Consecutive patients with MS attending the Neurology service in a tertiary hospital were recruited. Inclusion criteria consisted of people with MS over the age of 18, EDSS of ≥ 3 and able to give informed consent. Clinical data set collected included the EDSS score (level of disability), time since diagnosis, type of MS and walking aid(s) used. Falls diaries provided for 3 month period recording no of falls, and information about the circumstances, causes, and consequences of their falls. 

What were the findings?

Falls status was available for 100 participants. Mean age was 52.6(10.7) years and 66% were female. Mean EDSS was 5.3(1.1) and mean time since diagnosis was 14.3(9) years. 72.3% of the sample had progressive MS with 73% using a mobility aid. There were 791 falls reported over the three month period from a total of 56 participants. 54% of fallers experienced more than two falls throughout this period (frequent fallers). 59% of fallers reported an injurious fall. 94 injurious falls were reported in total, an average of 1.7 injurious falls per faller. Most common injuries were leg bruises (31%), arm bruises (26%) and arm cuts/scrapes (12%). 11% needed medical attention (n=3 accessed the emergency department). The most common cause of falls reported were poor balance (25%), weakness in the legs (22%) and fatigue (14%). Afternoon time (37%) was the most common time of day to fall, followed by evening (26%). The majority of falls occurred inside the home (63%). 34% of fallers needed help to get up after a fall and 9% of fallers lay on the floor for at least 10 minutes but none experienced a long lie (more than 60 minutes).

Who was involved?

Prof Susan Coote, of the University of Limerick, and Dr Christopher McGuigan, of St Vincent’s University Hospital, are leading this project. PhD candidates Gillian Quinn and Laura Comber, in addition to Dr. Etienne J Bisson, Dr. Marcia Finlayson and Dr. Rose Galvin complete this research team.