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American Journal of Physical Medicine & Rehabilitation:
doi: 10.1097/PHM.0000000000000049
Original Research Articles

Exploring Physical Activity in Women with Multiple Sclerosis: Associations with Fear of Falling and Underlying Impairments

Kasser, Susan L. PhD; Jacobs, Jesse V. PhD; Littenberg, Benjamin MD; Foley, John T. PhD; Cardinal, Bradley J. PhD; Maddalozzo, Gianni F. PhD

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Objective: The aim of this study was to conduct an exploratory analysis of fear of falling (FoF), balance, gait, and strength impairments and future physical activity in women with multiple sclerosis.

Design: This prospective study followed a convenience sample of 99 women with multiple sclerosis for 1 yr. The participants were assessed on FoF and perceived mental health by questionnaire. Objective measures included Limits of Stability, the Sensory Organization Test, and the Functional Ambulation Profile. Strength was quantified by knee extensor power asymmetry. Activity-specific metabolic equivalent values were used to determine minutes per week of moderate and vigorous physical activity.

Results: Future physical activity most strongly associated with baseline FoF (R2 = 0.09, P < 0.01), and baseline FoF associated with limits of stability and lower extremity strength asymmetry (R2 = 0.21, P < 0.001). Follow-up FoF is best predicted by initial levels of FoF independent of intervening falls (β = 3.26, P < 0.001).

Conclusions: Future physical activity of women with multiple sclerosis was best predicted by FoF independent of physical and mental functioning. Increased FoF was associated with greater lower extremity strength asymmetry and decreased limits of stability rather than with the experience of falls.

© 2014 by Lippincott Williams & Wilkins


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