Falls Common Among Multiple Sclerosis Patients in Wheelchairs, Scooters

Falls are prevalent in wheelchair and scooter users who are multiple sclerosis (MS) patients and are a growing area of concern, according to a recent report.

Researchers from the University of Illinois at Urbana-Champaign observed 44 people with MS in order to determine the prevalence and circumstances of falls in these devices for this population. The patients completed a survey which asked about the prevalence of falls, the frequency of injurious falls, circumstances of the fall, and various quality of life indicators on top of basic demographic questions.

Three-quarters of the study participants reported falling at least once in the prior 6 months, the researchers learned. The majority of falls occurred inside the home, while only 9.4% occurred outside. Recent similar studies found that an elevated fear of falling may contribute to recurrent falls in MS patients.

The study authors commented that falls are common in patients with MS, and about half of ambulatory patients reported falling within a 6-month period.

“The high frequency of falls occurring among this population was most surprising to me,” study author Laura Rice (pictured), PhD, told MD Magazine. “Frequently, clinicians feel that use of a wheelchair or scooter reduces the risk of falling. While a wheelchair or scooter can be an important tool, our data indicate that falls still occur at a high frequency and additional interventions are necessary.”

Falls often result in injuries that require medical attention and may even have dire consequences, such as hip fractures. This hazard can lead to a fear of falling, which can also produce activity curtailment and community participation limitation, psychological deconditioning, loss of independence, and institutionalization for the patients. The study authors suggested that evidence-based education programs should be implemented to manage this problem.

Additionally, this had been understudied in MS patients, the study authors added; even the National MS Society’s “Free from Falls” research program excludes patients who primarily use a wheelchair or scooter.

The 4 most reported activities the patients explained they were doing during their fall were using the toilet (20%), transferring (14%), walking short distances (13%), and reaching for an object (14%). Other activities included moving in bed, cooking, lifting a heavy object, and pushing or being pushed in a wheelchair.

A majority of the patients surveyed (n=33) noted they had concerns about falling, while 29 said they limited the activities they perform due to their concerns about falling. An additional 12 patients were asked if they contacted a medical professional as a result of the injury they sustained after a fall: 4 said yes, 8 said no.

“Physicians must take into consideration the high frequency of falls that occur among wheelchair and scooter users with MS and should discuss fall risk with their patients,” Rice concluded. In the paper, the study authors added that while a recommendation for a wheelchair or scooter might manage fall risk, many individuals continue to ambulate and sustain falls.

The paper was published in the journal Medicine.