Factors Involved in the Risk of Falls in People with Multiple Sclerosis: A Case-control Study.

Abstract

Introduction: The mobility of people with multiple sclerosis (pwMS) is significantly limited due to the involvement of the musculoskeletal system, resulting in falls and a diminished quality of life. This study aimed to assess the risk of falls (utilizing the Downton scale) and its association with spasticity and other variables in pwMS and compare it with a group of healthy participants.

Methods: This descriptive and cross-sectional observational study involved 86 subjects, divided into two groups: cases (n=41) and controls (n=45). All participants completed the Spanish version of the Downton Scale.

Results: There was a significant statistical association (p<0.05) in all dimensions of the Downton Scale, except for medications (significant in antihypertensives), showing increased levels of disability and barriers in pwMS. The case group, comprising pwMS, exhibited a significantly higher risk of falls, with a mean score of 2.37 ± 1.76, whereas the healthy subjects scored significantly lower at 0.44 ± 0.62. Additionally, the pwMS displayed notably higher association levels of spasticity compared to the healthy group.

Discussion: The study emphasizes that spasticity significantly increases the risk of falls in pwMS, reinforcing the Downton scale's utility in identifying high-risk individuals. However, limitations such as a non-diverse sample and the absence of comparison with other neurological conditions suggest the need for broader, more inclusive future research.

Conclusion: This study confirms that pwMS face a greater risk of falls compared to their healthy counterparts. Factors such as spasticity, visual impairments, and hearing problems significantly contribute to this increased risk.