Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Link Between Physiological and Perceived Fall Risk

Arch Phys Med Rehab; 2018 Oct; Gunn, et al

A recent study highlights the importance of considering both physiological and perceived fall risk in multiple sclerosis (MS) and the need to explore the complex interrelationships of perceptual and physiological risk factors in this population. Researchers conducted a secondary analysis of data from prospective cohort studies undertaken in the US, Australia, and the UK. The cohort consisted of ambulatory people with MS (n=416). All participants completed measures of physiological (Physiological Profile Assessment [PPA]) and perceived (Falls Efficacy Scale-international [FESi]) fall risk and prospectively recorded falls for 3 months. They found:

  • 155 (37%) of the participants were recurrent fallers (≥2 falls).
  • The PPA and the FESi independently predicted faller classification in logistic regression, which indicated that the odds of being classified as a recurrent faller significantly increased with increasing scores.
  • Classification and regression tree analysis divided the sample into 4 groups based on cutoff values for the PPA: 1) low physiological/low perceived risk, 2) low physiological/high perceived risk, 3) high physiological/low perceived risk, and 4) high physiological/high perceived risk.
  • Over 50% of participants had a disparity between perceived and physiological fall risk; most were in group 2.


Gunn H, Cameron M, Hoang P, Lord S, Shaw S, Freeman J. Relationship between physiological and perceived fall risk in people with multiple sclerosis: Implications for assessment and management. Arch Phys Med Rehab. 2018; 99(10):2022-2029. doi:10.1016/j.apmr.2018.03.019.

This Week's Must Reads

Examining Brain Markers for Late-Onset Epilepsy, Neurology; ePub 2019 Jan 25; Johnson, et al

Hearing Loss Linked Cognitive Decline Risk in Men, Alzheimers Dement; ePub 2019 Jan 29; Curhan, et al

Brain Cholesterol Metabolism and PD Examined, Mov Disord; ePub 2019 Jan 25; Huang, et al

Sleep Behavior Disorder, Clinical Progression in PD, Parkinsonism Relat Disord; ePub 2019 Jan 29; Duarte Folle, et al

Spontaneous Subarachnoid Hemorrhage During Pregnancy, J Stroke Cerebrovasc Dis; ePub 2019 Jan 30; Limaye, et al

Must Reads in Multiple Sclerosis

Prevalence of Asthma in Persons with MS, Mult Scler Relat Disord; ePub 2018 Dec 11; Hill, et al

Normal-Appearing White Matter in MS Examined, Neuroradiology; ePub 2018 Dec 12; Yu, et al

MS Disease Burden: Which Symptoms Matter Most?, Mult Scler Relat Disord; 2018 Oct; Barin, et al

Retinal Layer Thickness and MS Conversion Risk, Mult Scler; ePub 2018 Dec 3; Filippatou, et al

Importance of Coping and QOL in People with MS, Int J MS Care; ePub 2018 Dec 6; Grech, et al