Falls in people with multiple sclerosis: experiences of 115 fall situations

OBJECTIVES The aim was to describe falls and the perceived causes, experienced by people with multiple sclerosis shortly after falling. DESIGN A qualitative study using content analysis and quantitative data to illustrate where and why people report falls most commonly. Semi-structured telephone interviews were performed. Interviews were conducted shortly (0-10 days) after a fall. SUBJECTS In all, 67 informants who had reported at least one fall during the previous three-month period and who used a walking aid participated. RESULTS A total of 57 (85%) informants fell at least once during eight months resulting in 115 falls; 90 (78%) falls happened indoors, most commonly in the kitchen ( n = 20; 17%) or bathroom ( n = 16; 14%). Informants fell during everyday activities and walking aids had been used in more than a third of the reported falls. The falls were influenced of both intrinsic and extrinsic factors. Two categories emerged from the analysis: 'activities when falling' and 'influencing factors'. The category contained three (basic activities of daily living, instrumental activities of daily living and leisure and work) and six (multiple sclerosis-related symptoms, fluctuating body symptoms, being distracted, losing body control, challenging surrounding and involvement of walking aid) subcategories, respectively. CONCLUSION The majority of falls occurs indoors and in daily activities. Several factors interacted in fall situations and should be monitored and considered to reduce the gap between the person's capacity and the environmental demands that cause fall risk. Fluctuation of bodily symptoms between and within a day is a variable not earlier targeted in multiple sclerosis fall risk research.