Objectives: To compare, in PwMS, how well the FES-I and the ABC scale predict who will fall in the following 6 months.
Methods: Subjects were 58 PwMS, aged 18-50 years, with Expanded Disability Status Scale scores ≤ 6.0 participating in a prospective study of mechanisms of imbalance in MS. Subjects completed the FES-I, the ABC scale and six monthly prospective fall calendars. The t-test was used to compare mean scores on the FES-I and the ABC between those who fell and those who did not fall in the following 6 months. Receiver Operating Characteristics (ROC) curves were generated to assess the accuracy of the FES-I and the ABC in predicting the presence or absence of falls in the following 6 months. The areas under the ROC curves were compared using chi-square test. Stata version 12 was used for all statistical analysis.
Results: 53 subjects completed the study and were included in the analysis. 37 subjects fell at least once in the 6-month period. Mean FES-I and ABC scores were significantly different for those who did or did not fall in the following 6 months (FES-I: fallers 27.8 ± 10.2 versus non-fallers 21.4 ± 5.8; p=0.03. ABC: fallers 74.4 ± 21.7 versus non-fallers 87.9 ± 15.6; p=0.03). Area under the curve (AUC) for the FES-I was 0.698 and for the ABC was 0.727. These AUCs were not significantly different (p=0.39).
Conclusions: The FES-I and the ABC scale have a similar ability to predict which PwMS will or will not fall in the following 6 months. Thus, to identify PwMS who are at risk for falling, the use of either scale as a screening tool is justified. Further research is required to investigate the multifactorial temporal relationship among concern for falling, confidence in avoiding falls, fear of falling, and actual fall events.