Coping with falls by people with multiple sclerosis: a focus group study

Background: Abnormalities in balance control are common in people with Multiple Sclerosis (Frzovic & Morris, 2000) and can, along with other impairments and disabilities, often prevent peopleperforming their daily living activities (Cattaneo et al, 2002). Many of the symptoms common to Multiple Sclerosis (MS) are consistent with fall risk factors among community-dwelling older adults (Gold et al, 2001). The risk of injurious falls may be greater among people with MS because of their reduced weight-bearing activities and the use of steroidsfor symptom management (Cosman et al, 1998 & Gold et al, 2001). Given the apparent risk of falls among people with MS, the lack of information regarding fall with this population is surprising (Marcia et al, 2006). Knowing circumstances in which people fall allows therapists to address them specifically (Ashburn et al, 2008). Objective: A focus group study was undertaken to gain an insight into frequency of falls/near fall incidents, to establish the most common reasons why these incidents occur and to understand consequencesof falls for people with MS. Participants: Participants enrolled in a randomized controlled trialinvestigating the effects of exercise therapy for mobility and balance in people with MS, were invited to participate. The inclusion, exclusion criteria for participants mirrored those of the RCT. Method: A total of four out of nine participants from the RCT agreed to participate. Interviews were recorded, transcribed verbatim and independently coded by two researchers. Thematic analysis was used to identify themes.Results: Participants revealed balance and mobility problems related to MS impacted on their lives and falls were an issue for all participants. Issues were classified into physical activity and environmental categories; physical problems included limb heaviness and loosing balance whereas environmental problems included uneven surfaces. Activities included standing, walking and distractions. Physical consequences included the use of aids, walking indoors and working hours. Emotional consequences included reduced confidence and awareness of others perceptions.Conclusion: Findings will offer an insight to clinicians, therapists and researchers in this under researched area in order to gain a better understanding of causes and consequences of falls for adults with MS. Results will also be used to design further studies on falls in terms of their management and measurement in people with MS.