Why do some people with MS fall?
Why do some people with MS fall?
Multiple sclerosis is an unpredictable, often disabling disease of the central nervous system that disrupts the flow of information within the brain, and between the brain and body. An estimated 2.3 million people live with MS worldwide. It is associated with a wide range of symptoms. A common effect of MS is impaired mobility including
difficulty walking.
Because of mobility challenges and other symptoms, people with MS may be at significant risk for falls and the potentially life-changing consequences of fall-related injuries. Studies have shown that approximately half of middle-aged and older individuals with MS experience at
least one fall over a six-month period.
Various physical symptoms place people with MS at risk of falling, but there are psychological risks as well. As MS changes over time and walking becomes more difficult, you may find that you resist accepting help. Being able to walk confidently and independently is important, so the idea of losing that independence may be frightening. Tools and tips that can prevent future falls will help to keep you more independent rather than take your independence away… being receptive to them is half the battle.
adobe.stock.imageRisk factors for falling
Biological risk factors:
Understanding MS symptoms In MS, damage to the myelin sheath (a substance that protects nerve fibers) in the central nervous system — as well as to the nerve fibers themselves — interferes with the transmission of nerve signals between the brain and spinal cord and other parts of the body. This disruption leads to the following symptoms that may put a person with MS at risk for falling: Walking, balance and coordination problems
Difficulties with walking are the result of several factors:
■ Weakness — Muscle weakness is common in MS and can cause gait problems such as toe drag or foot drop. Weakness can also cause knee, hip or ankle instability.
■ Spasticity — Spasticity is one of the most common symptoms of MS and is a major contributor to falls. The term spasticity refers to feelings of stiffness and a reduced ability to maintain smooth, controlled movements of a limb. It may be as mild as a feeling of tight muscles, or may be so severe as to produce painful, uncontrollable spasms. Although spasticity can occur in any limb, it is much more common in the legs. When spasticity is present, a great deal of energy must be expended while walking.
■ Loss of balance — Balance problems typically result in a swaying or uncoordinated type of walking known as ataxia.
■ Dizziness and vertigo — Dizziness can also occur in MS. This may appear as the feeling of being off balance or lightheaded. Much less often, there is a sensation that one’s surroundings are spinning; this condition is known as vertigo.
■ Sensory deficits —Numbness and other sensory disturbances are often the first presenting symptoms of MS. Numbness can make it difficult to be aware of the position of one’s feet or other body parts, and may make it difficult to walk on uneven or unstable terrain. Tingling or burning sensations may occur, which can also interfere with function.
■ Tremor — Fine, rapid, back and forth movements of the limbs and the head can occur with MS. These tremors can often interfere with balance and coordination.
Fatigue
Fatigue is another common symptom of MS, occurring in more than 80% of people with the disease. MS fatigue is commonly described as a feeling of exhaustion that is unrelated to an individual’s level of exertion. This differs from muscle fatigue that results from exertion. When present, fatigue can worsen all of the other symptoms that contribute to mobility problems, thus increasing the risk of falling.
Heat intolerance
Even a very slight increase in body temperature can temporarily worsen MS symptoms and contribute to an increased risk of falling. An increase in temperature may result from either illness-related fever or from a temporary elevation in body temperature caused by hot weather, high
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