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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

American Journal of Physical Medicine & Rehabilitation: June 2014 - Volume 93 - Issue 6 - p 461–469
doi: 10.1097/PHM.0000000000000049
Original Research Articles

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 (R 2 = 0.09, P < 0.01), and baseline FoF associated with limits of stability and lower extremity strength asymmetry (R 2 = 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.

From the Department of Rehabilitation and Movement Science (SLK, JVJ) and Department of Medicine (BL), University of Vermont, Burlington, Vermont; Department of Physical Education, State University of New York at Cortland, Cortland, New York (JTF); and School of Biological and Population Health Sciences, Oregon State University, Corvallis, Oregon (BJC, GFM).

All correspondence and requests for reprints should be addressed to: Susan L. Kasser, PhD, Department of Rehabilitation and Movement Science, University of Vermont, 306 Rowell Bldg, 106 Carrigan Dr, Burlington, VT 05405.

Supported by the National Multiple Sclerosis Society (grant no. PP0848) and the John C. Erkkila, M.D., Endowment for Health and Human Performance, Good Samaritan Hospital Foundation, Corvallis, OR.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2014 by Lippincott Williams & Wilkins