Document Type


Degree Name



Dept. of Public Health and Preventive Medicine


Oregon Health & Science University


Background: People with multiple sclerosis (MS) fall frequently and there is a paucity of clinically valid tools to measure the risk factors for falls. Objective: To assess the unidimensionality of the 7-item Falls Efficacy Scale-International (FES-I), a measure of fear of falling and to determine if the 7-item FES-I predicts recurrent falls in people with MS. Methods: Falls were counted prospectively for 6 months using fall calendars in 58 people with MS, aged 18-50 years with an Expanded Disability Status Scale (EDSS) score of 0-6. The FES-I was administered at baseline. Unidimensionality of the 7-item FES-I was assessed by confirmatory factor analysis. The relationship between FES-I score and future falls, after adjusting for recurrent falls in the past year was assessed by logistic regression. Results: Fifty-four participants completed all assessments were included in the analysis. Goodness-of-fit indices confirmed a single factor solution for the 7-item FES-I (Discrepancy Chi-2, p=0.101; Tucker-Lewis Index: 0.953; Comparative Fit Index: 0.969; RMSEA: 0.098). There was a statistically significant association between fear of falling, and falls in the following 3 months, independent of recurrent falls in the past year (OR: 1.22 CI: 1.04-1.43, p=0.016). Conclusion: The 7-item FES-I demonstrates good construct validity allowing the total score to be used as a measure of fear of falling in people with MS. Fear of falling, as measured by the 7-item FES-I, is associated with future recurrent falls independent of past recurrent falls in people with MS.




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