Exploring Factors Associated with Falls in Multiple Sclerosis: Insights from a Scoping Review

Figures & data

Figure 1 Literature search flowchart.

Table 1 An Overview of the 18 Studies Included in the Scoping Review

Study Author/Year (Reference)	Study design	Number of MS Patients/Female	Age range /Mean in Years	Duration of Falls	Severity of MS (EDSS)	Type of MS	Association Factors or the Cause of Falls
Abasıyanık et al 2021^Citation10	Cross-sectional study	104/ F:77	Mean: 33.41 F 35.96 NF: 32.56	3 months	Range: ≤ 1.5 mean: 0.69	RRMS	EDSS score
Soll et al 2021^Citation14	Cross -sectional study	44/ F:44	Mean: 46	1 year	Range:3.0–6.0. median: 4.5	NR	Fear of falling in patient with bladder dysfunction
Gunn et al 2013^Citation15	Prospective cohort study	148/ F:114	Mean: 57.9 F: 57 NF: 59	3 months	Range: 3.5–6.5	RRMS PPMS SPMS	Loss of balance Using walking stick or elbow crutch
Kalron et al 2013^Citation12	Cross-sectional study	107/ F: 62	F: 45.3 NF: 47	6 months	Mean: 2.8	RRMS	Old age Longer disease duration Greater level of EDSS impairment in pyramidal, cerebellar, and sensory function concern of falling
Kalron et al 2017^Citation16	Cross-sectional study	540/ F:333	NR	1 year	Median: 2.5	NR	Lower global cognitive performance
Mofateh et al 2017^Citation17	Retrospective cohort study	50/ F:40	Range: ≥ 18	6 months	Mean: 4.16	RRMS	Higher EDSS Gait variability Decreased muscle strength Spasticity Fatigue Increased postural sway
Zelaya et al 2017^Citation14	Prospective cohort study	51/ F:36	Range: 18–50 Mean: 39.6 F: 39.8 NF: 39.1	3 months	Median: 3	RRMS	Urinary urgency with incontinence
Gunn et al 2018^Citation18	Secondary analysis of data from prospective cohort studies	416/ F: 305	Range: ≥ 18 Mean: 51.5	3 months	Median: 4.0	RRMS	Impaired proprioception, quadriceps muscle strength, simple reaction time, visual contrast sensitivity, and postural sway
Karlon et al 2018^Citation19	Cross-sectional study	122/ F:75	Mean: 43	1 year	Mean: 2.9	NR	Depression
Mazumder et al 2014^Citation4	Prospective cohort study	58/ F:34	Range: 18–50 Mean: 39.7	6 months	Median 3.0	RRMS	Loss of balance (most common) Fatigue Heat Tripping Distraction
Kalron et al 2014^Citation13	Retrospective cohort study	101/ F:60	F: 43.2 NF: 38.8	1 year	Mean: 3.0 F: 3.6 NF: 2.2	RRMS	EDSS Concern of falling Cognitive performance less (attention and verbal function)
Kalron et al 2018^Citation20	Cross-sectional study	355/ F:218	Mean: 41.1 F: 43.6 NF: 39.5	1 year	Median: 2.5	NR	Higher EDSS Longer disease duration Slower walking speed
Karlon et al, 2016^Citation21	Cross-sectional study	342/ F:211	Mean: 46.6	1 year	Mean 3.8	NR	MS affected in pyramidal system EDSS
Cameron et al 2015^Citation22	Prospective cohort study	248/ F:178	Range: 21–74 Mean: 48.5 F: 48.8 NF: 48.1	6 months	Mean: 3.10	RRMS PPMS SPMS	The use of more medications The use of MS disease-modifying therapies is associated with fewer falls Antidepressants was associated with 96% increased odds of falling
Mazumder et al 2015^Citation15	Prospective cohort study	58/ F:37	Range: 18–50 Mean: 39.6 F: 40.4 NF: 38.25	6 months	Mean: 2.7	RRMS PPMS SPMS	Fear of falling
Karlon et al 2019^Citation23	Cross-sectional study	88/ F:50	Mean: 39.8 F: 42.1 NF: 38.5	3 months	Mean: 2.0	RRMS	Higher step length variability
Khalil et al 2017^Citation24	Cross-sectional study	70/ F:50	Mean: 34.3	12 months	Mean: 2.3	RRMS	Fear of falling
Gunn et al/2014^Citation11	Prospective cohort study	148/ F: 114	Mean: 57 F: 57 NF: 59	3 months	Median F: 5.5 NF: 5.5	RRMS PPMS SPMS	Continence issues History of falls Men

Abbreviations: No, Number; MS, Multiple sclerosis; EDSS, Expanded disability status scale; F, Female; EDSS, Expanded Disability Status Scale; NR, Not reported; RRMS, Relapse-remitting MS; PPMS, Primary-progressive MS; SPMS, Secondary-progressive MS; BMS, Benign MS. F, Fallers; NF, Non-fallers; MS1, no clinical gait impairment; MS2, clinical gait impairment.

Figure 2 Factors associated with falls in Multiple Sclerosis.

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