After a fall, more than a quarter of MS patients report delayed initial recovery of laying on the floor or ground for more than 10 minutes, and a smaller fraction reported a long lie of 1 hour or more, according to a secondary analysis of 700 patients ages 55 and older from the North America Committee on Multiple Sclerosis registry.
Researchers used participants’ self-reported information about their most recent fall to determine rates of delayed initial recovery and a long lie and found:
• Of the 322 patients with fall information, 27.6% reported delayed initial recovery and 4.7% reported a long lie.
• Factors associated with delayed initial recovery include longer disease duration (odds ratio [OR], 1.03), fall leading to fracture (OR, 2.73), needing help to get up (OR, 3.94), depression (OR, 1.96), and leg weakness (OR, 2.14).
Citation: Bisson EJ, Peterson EW, Finlayson M. Delayed initial recovery and long lie following a fall among middle-aged and older adults with multiple sclerosis. Arch Phys Med Rehabil. 2015. pii: S0003-9993(15)00378-0. doi:10.1016/j.apmr.2015.04.012.
Commentary: MS is a chronic disease that impacts patients in many different ways. Concerns are typically focused on relapse rates and MRI changes. Disease burden may include limitation of ambulation, impaired balance or vision, and cognitive problems. All of these problems might result in increased risk of falling. Economic impact related to MS also includes factors related to falling. Increased risk of falls—and the subsequent fear of falling—might limit independence and reduce quality of life. The costs related to injury from falling, restricted daily activities from this fear of falling, and attendant anxiety are not only likely significant costs but chronic costs as well. This article points out that fall risk evaluation and fall prevention are unmet needs in the continuum of MS care. — Mark Gudesblatt, MD, Medical Director of the Comprehensive MS Care Center at South Shore Neurologic Associates in Islip, NY