Citation

Soll R, Greenberg T, Dolev M, Kalron A. Gait Posture 2021; 88: 252-257.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.gaitpost.2021.06.010

PMID

unavailable

Abstract

BACKGROUND: Bladder dysfunction is the most common autonomic disturbance in people with MS (PwMS). Only a few studies have examined the relationship between bladder dysfunction and falls in PwMS. Bladder dysfunction has been deemed only a secondary outcome measure, and classified by a gross measure providing a limited perspective of this disturbing symptom. Furthermore, no study to date has focused on the relationship between bladder dysfunction and balance performance in PwMS. RESEARCH QUESTION: Determine the relationship between bladder dysfunction with balance, falls and fear of falling in women with MS.

METHODS: The study was observational, including 44 women with MS, mean age 46.3 (SD = 5.7), all with at least a mild bladder dysfunction. Outcome measures included the Urinary Incontinence Quality of Life Scale (I-QoL), Bladder Control Scale (BLCS), Timed Up and Go Test (TUG), Four Square Step Test (FSST), Falls Efficacy Scale International (FES-I), Falls status, and posturography.

RESULTS: Participants performed the TUG in 14.1 s (S.D. = 11.1), and the FSST in 20.5 s (S.D. = 22.4). A relatively large proportion (68.2 %) of women was classified as fallers. However, no differences were found between those classified as fallers (n = 30) or non-fallers (n = 14) in terms of the I-QoL and the BLCS, controlling for age, EDSS and number of vaginal deliveries. Significant correlations scores were found between the I-QoL, BLCS and FES-I (rho ∼0.47), while controlling for age, EDSS and number of vaginal deliveries. No associations were demonstrated between the bladder dysfunction outcome scores and either the TUG and/or FSST. SIGNIFICANCE: Women afflicted with MS and suffering from bladder dysfunction tend to fall and present with more balance difficulties compared with disability-matched PwMS. Nevertheless, once bladder dysfunction is detected, the perceived severity of the condition is not associated with balance and prevalence of falling, but rather on fear of falling.

Language: en

Keywords

Falls; Balance; Multiple sclerosis; Fear of falling; Bladder dysfunction; Urinary incontinence