Correlation of falls in patients with Amyotrophic Lateral Sclerosis with objective measures of balance, strength, and spasticity.
Wendy E Schell, Victoria S Mar, Carolyn P Da Silva
PMID 30714981WHAT IT FOUND
In ambulatory adults with ALS, lower-limb strength was related to recent self-reported falls.
Walking speed, spasticity, and Berg Balance scores were not.
Key findings
01Participants reported an average of 5.45±8.56 falls in the previous three months.
02A lower-limb strength composite score was significantly correlated with number of reported falls (p = 0.032).
03Gait speed, lower-limb spasticity, and Berg Balance Scale score were not significantly correlated with number of reported falls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 31 participants were included, and all had to be able to ambulate 20 feet, so it says nothing about people with ALS who cannot walk that distance. Falls were self-reported for the previous three months, so the count may be inaccurate; the authors suggest caregiver or family report may improve accuracy. The study used strict inclusion and exclusion criteria, which the authors say limited sample size and study power. The paper's text describes the strength-falls correlation as positive, but the results table lists it as negative, so the direction is unclear. It measured associations at a clinic visit, so it cannot show whether these measures predict future falls or whether treatment changes fall risk.
The easy way to misread this
Do not conclude that a strength programme will reduce falls in ALS. This study only found a correlation with self-reported recent falls in people who could ambulate 20 feet, and it did not test a treatment or follow patients over time.