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dc.contributor.authorGunn, HJ
dc.contributor.authorCameron, M
dc.contributor.authorHoang, P
dc.contributor.authorLord, S
dc.contributor.authorShaw, S
dc.contributor.authorFreeman, J
dc.date.accessioned2018-04-23T11:55:05Z
dc.date.issued2018-10
dc.identifier.issn0003-9993
dc.identifier.issn1532-821X
dc.identifier.urihttp://hdl.handle.net/10026.1/11325
dc.description.abstract

OBJECTIVE: This study evaluated the relationship between physiological and perceived fall risk in people with multiple sclerosis (MS). DESIGN: Secondary analysis of data from prospective cohort studies undertaken in Australia, the United Kingdom, and the United States. SETTING: Community. PARTICIPANTS: Ambulatory people with MS (N=416) (age 51.5±12.0 years; 73% female; 62% relapsing-remitting MS; 13.7±9.9 years disease duration). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: All participants completed measures of physiological (Physiological Profile Assessment [PPA]) and perceived (Falls Efficacy Scale-international [FESi]) fall risk and prospectively recorded falls for 3 months. RESULTS: 155 (37%) of the participants were recurrent fallers (≥2 falls). Mean PPA and FESi scores were high (PPA 2.14±1.87, FESi 34.27±11.18). The PPA and the FESi independently predicted faller classification in logistic regression, which indicated that the odds of being classified as a recurrent faller significantly increased with increasing scores (PPA odds ratio [OR] 1.30 [95% CI 1.17-1.46], FESi OR 1.05 [95% CI 1.03-1.07]). Classification and regression tree analysis divided the sample into four groups based on cutoff values for the PPA: (1) low physiological/low perceived risk (PPA <2.83, FESi <27.5), (2) low physiological/high perceived risk (PPA <2.83, FESi >27.5), (3) high physiological/low perceived risk (PPA >2.83, FESi <35.5), and (4) high physiological/high perceived risk (PPA <2.83, FESi >35.5). Over 50% of participants had a disparity between perceived and physiological fall risk; most were in group 2. It is possible that physiological risk factors not detected by the PPA may also be influential. CONCLUSIONS: This study highlights the importance of considering both physiological and perceived fall risk in MS and the need for further research to explore the complex interrelationships of perceptual and physiological risk factors in this population. This study also supports the importance of developing behavioral and physical interventions that can be tailored to the individual's needs.

dc.format.extent2022-2029
dc.format.mediumPrint-Electronic
dc.languageen
dc.language.isoen
dc.publisherElsevier
dc.subjectAccidental falls
dc.subjectCohort studies
dc.subjectMultiple sclerosis
dc.subjectRehabilitation
dc.titleThe relationship between physiological and perceived fall risk in people with multiple sclerosis: implications for assessment and management
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/29698641
plymouth.issue10
plymouth.volume99
plymouth.publication-statusPublished
plymouth.journalArchives of Physical Medicine and Rehabilitation
dc.identifier.doi10.1016/j.apmr.2018.03.019
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/School of Health Professions
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA03 Allied Health Professions, Dentistry, Nursing and Pharmacy
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Health and Community
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
plymouth.organisational-group/Plymouth/Users by role/Researchers in ResearchFish submission
dc.publisher.placeUnited States
dcterms.dateAccepted2018-03-27
dc.rights.embargodate2019-4-24
dc.identifier.eissn1532-821X
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1016/j.apmr.2018.03.019
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2018-10
rioxxterms.typeJournal Article/Review


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