Association Between Lower Limb Spasticity and Falls in Persons with Multiple Sclerosis

INTRODUCTION: Falls and spasticity are among the most prevalent complaints in persons with multiple sclerosis (pwMS). Limited evidence exists on the direct relationship between lower limb spasticity and falls in pwMS. This study aimed to explore the association between lower limb spasticity, walking, and falls in pwMS.
METHODS: Thirty-nine patients were included (age: 35.4±9.52; 54% female, 46% male). The timed 25-foot walk (T25FW) and multiple sclerosis walking scale-12 (MSWS-12) were applied to evaluate walking. Participants reported their number of falls within the last three months. The severity of spasticity in lower limb muscles, comprising hip adductors, knee flexors and extensors, and plantar flexors, was tested using the modified ashworth scale.
RESULTS: Fifteen participants were fallers. Spasticity levels in the ankle plantar flexors were significantly greater (p=0.009) in fallers. The number of falls correlated with ankle plantar flexors and knee extensors (rho=0.497, rho=0.329; p<0.05, respectively). The severity of spasticity in all muscle groups was negatively correlated with walking (rho=0.335-0.692, p<0.05).
DISCUSSION AND CONCLUSION: There was a significant correlation between the degree of ankle plantar flexor and knee extensor spasticity and the number of falls in pwMS. This significant association between spasticity and fall history highlights the importance of designing therapeutic interventions optimizing lower limb spasticity.