Fall history moderates the relationship between concern about falling and reactive stepping performance in people with multiple sclerosis.

Abstract

Background: Reactive balance (quick motoric responses to an external balance challenge) and affective characteristics are linked to falls and negatively impacted in people with multiple sclerosis (MS). While previous studies indicate a potential link between these outcomes, little work has systematically evaluated these relationships, particularly in people with MS. The goal of this study was to assess the association between reactive balance and affect in people with MS, and whether fall-status moderates this relationship.

Experimental procedures: Reactive balance, affect, and fall status were collected cross-sectionally in 109 people with MS. Reactive balance length and latency (in forward and backward directions) were related to Activities of Balance Confidence (ABC) and the Falls Efficacy Scale International (FES-I; both continuous and dichotomous preparations) via linear models with and without retrospective fall status as a co-variate.

Results: We observed significant relationships between reactive stepping and affect. Relationships were more pronounced in backward losses of balance (rather than forward), and in temporal (step latency) rather than spatial (step length) outcomes. Finally, fall status moderated the reactive balance-affect relationship, such that people with MS and a fall history had a stronger and steeper relationship to affect than those without a fall history.

Discussion: These data support a link between concerns of falling and reactive balance responses, both closely related to fall-risk. This information improves our understanding of maladaptive behaviors leading to falls, which may facilitate identification of targets to reduce falls and their sequelae.