Motor Cognitive Dual-Task Testing to Predict Future Falls in Multiple Sclerosis: A Systematic Review

Libak Abou, Joseph Peters, Nora E. Fritz, Jacob J. Sosnoff, Anna L. Kratz

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Mobility and cognitive impairments are often associated with increased fall risk among people with multiple sclerosis (PwMS). However, evidence on the concurrent assessment of gait or balance and cognitive tasks (dual-task) to predict falls appears to be inconsistent. Objective: To summarize the ability of gait or balance dual-task testing to predict future falls among PwMS. Methods: Seven databases including PubMed, Embase, Web of Science, Scopus, CINHAL, SPORTDiscuss, and PsycINFO were searched from inception to May 2022. Two independent reviewers identified studies that performed a dual-task testing among adults with multiple sclerosis and monitored falls prospectively for at least 3 months. Both reviewers also evaluated the quality assessment of the included studies. Results: Eight studies with 484 participants were included in the review. Most studies (75%) indicated that dual-task testing and dual-task cost did not discriminate prospective fallers (⩾1 fall) and non-fallers (0 fall) and were not found as predictors of future falls. However, dual-task cost of walking velocity (OR = 1.23, 95% CI 0.98-4.45, P =.05) and dual-task of correct response rate of serial 7 subtraction (OR = 1.34, 95% CI 1.04-3.74, P =.02) were significantly associated with increased risk of recurrent falls (≥2 falls). Pattern of cognitive-motor interference was also associated with an increased risk of falling. All studies presented with strong quality. Conclusion: The scarce evidence indicates that dual-task testing is not able to predict future falls among PwMS. Further research with more complex motor and cognitive tasks and longer-term fall monitoring is required before dual-task testing can be recommended as a predictor of future falls in this population.

Original languageEnglish (US)
Pages (from-to)757-769
Number of pages13
JournalNeurorehabilitation and Neural Repair
Volume36
Issue number12
DOIs
StatePublished - Dec 2022

Keywords

  • accidental falls
  • cognition
  • dual-task
  • multiple sclerosis
  • psychomotor performance
  • risk factor

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology

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