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

Higher Cortisol Linked with Lower Brain Volume, Neurology; ePub 2018 Oct 24; Echouffo-Tcheugui, et al

Ischemic Stroke Transfers in the Northeastern US, J Stroke Cerebrovasc Dis; ePub 2018 Oct 30; Zachrison, et al

Predictors of Recurrent Hospitalizations Post-TIA, J Stroke Cerebrovasc Dis; ePub 2018 Oct 17; Yousufuddin, et al

Sleep Apnea Associated with Less Healthful Diet, Sleep; ePub 2018 Oct 22; Reid, Maras, Shea, et al

Hypertension, Obesity, Cognitive Decline Examined , Alzheimers Dement; ePub 2018 Oct 24; Clark, et al

Must Reads in Multiple Sclerosis

No Link Between Overall Diet, MS Risk in Women, Mult Scler; ePub 2018 Oct 23; Rotstein, et al

Pubertal Onset of MS and Relapses in Boys, Mult Scler Relat Disord; ePub 2018 Oct 22; Young, et al

FLAIR Signal and Venous Abnormalities Linked in MS, AJNR Am J Neuroradiol; ePub 2018 Oct 18; Rogers, et al

Diabetes and Anxiety Affect Cognition in MS, Mult Scler Relat Disord; ePub 2018 Oct 23; Marrie, et al

Illness Intrusiveness on Intimacy in Persons with MS, Qual Life Res; 2018 ePub 2018 Oct 17; Neto, et al