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This study targets determinants of falls in patients with low disability (EDSS \u003C 4.0) and evaluates how patient-reported outcome measures (PROMs) can support timely fall-prevention decisions. Fifty RRMS patients and thirty matched healthy controls underwent fall-history assessment, balance and gait testing, walking limitation evaluation, cognitive screening, depression measurement, and fear-of-falling scoring.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/proms-reveal-early-fall-risk-in-the-absence-of-clinical-disability-in-people-with-multiple-sclerosis/458037/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/proms-reveal-early-fall-risk-in-the-absence-of-clinical-disability-in-people-with-multiple-sclerosis/458037.png","ImageObject",300,407,{"name":92,"@type":93},"Hazel","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"Who participated in the study and how was disability level defined?","Question",{"text":112,"@type":113},"The study assessed fifty RRMS patients with EDSS \u003C 4.0 (aged 18–50) and thirty age-, sex-, and education-matched healthy controls.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which PROMs and assessments were used to evaluate fall and fear of falling risk?",{"text":117,"@type":113},"Participants reported fall history and were assessed with balance measures, gait speed via T25FW, walking limitations using MSWS-12, cognitive function (MoCA), depression (BDI-II), and fear of falling using FESI.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the main findings about falls and fear of falling in low-disability MS?",{"text":121,"@type":113},"Falls occurred in 48% of people with multiple sclerosis versus 30% of healthy controls, and fear of falling was significantly more common in the MS group. MS fallers had higher MSWS-12 and FES-I scores than non-fallers.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458037,1790792230,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":39,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":46,"preview_page_count":4},137441390410,"https://ap-avatar.wpscdn.com/avatar/2000252f4ab5702993?_k=1776741390130283984","Neurological Sciences (2026) 47:114  \n[https://doi.org/10.1007/s10072-025-08605-w](https://doi.org/10.1007/s10072-025-08605-w)  \nORIGINAL ARTICLE  \nPROMs reveal early fall risk in the absence of clinical disability in people with multiple sclerosis  \nNurşen Kurtuluş1 · Aysun Ünal1 · Bengü Altunan1 · Filiz Dilek2 · Aslı Aksoy Gündoğdu1 · Birol Topçu3  \nReceived: 12 May 2025 / Accepted: 28 November 2025 / Published online: 7 January 2026 © The Author(s) 2026  \nAbstract  \nBackground Falls and fear of falling (FoF) are common in people with multiple sclerosis (pwMS), even in the absence of significant physical disability. To identify the determinants of falls in pwMS with low disability (EDSS \u003C 4.0) and to examine the utility of patient-reported outcome measures (PROMs) in guiding timely fall prevention strategies.  \nMethods Fifty RRMS patients (EDSS \u003C 4.0, aged 18–50 years) and 30 age, sex, and education-matched healthy controls were assessed. Participants were evaluated for fall history (retrospective and prospective), static and dynamic balance, gait speed (T25FW), walking limitations (MSWS-12), cognitive function (MoCA), depression (BDI-II), and fear of falling (FESI). Correlation and regression analyses were conducted to identify factors associated with FoF.  \nResults Falls occurred in 48% of pwMS and 30% of healthy subjects (HC) (p = 0.1) . FoF was significantly more common in pwMS (50%) than in HCs (23.3%, p = 0.001). MS patients who fell had significantly higher MSWS-12 and FES-I scores than non-fallers (p = 0.001 and p = 0.01, respectively). FoF positively correlated with age, disease duration, EDSS, static balance, and MSWS-12, and negatively with education level. In linear regression, MSWS-12 (p\u003C 0.001) and disease duration (p = 0.03) were significant predictors ofFoF.  \nConclusion FoF is common among pwMS even at low disability levels and may contribute to fall risk and activity restriction. PROMs, particularly MSWS-12 and FES-I, are valuable tools for identifying fall-prone individuals and should be integrated into routine clinical assessments to enable early intervention.  \nKeywords Multiple sclerosis · Falls · Fear of falling · PROMs · MSWS-12 · Balance  \n􀀍 Aysun Ünal[aunal@nku.edu.tr](aunal@nku.edu.tr)  \nNurşen Kurtuluş  \n[nursentuman@hotmail.com](nursentuman@hotmail.com)  \nBengü Altunan  \n[baltunan@nku.edu.tr](baltunan@nku.edu.tr)  \nFiliz Dilek  \n[fdilek@nku.edu.tr](fdilek@nku.edu.tr)  \nAslı Aksoy Gündoğdu  \n[aagundogdu@nku.edu.tr](aagundogdu@nku.edu.tr)  \nBirol Topçu  \n[btopcu@nku.edu.tr](btopcu@nku.edu.tr)  \n1 Faculty of Medicine, Department of Neurology, Tekirdağ Namık Kemal University, Tekirdağ, Turkey  \n2 Vocational School of Health Services, Elderly Care Program, Tekirdağ Namık Kemal University, Tekirdağ, Turkey  \n3 Faculty of Medicine, Department of Biostatistics, Tekirdağ Namık Kemal University, Tekirdağ, Turkey  \nIntroduction  \nMultiple sclerosis (MS) is a chronic, inflammatory, immune-mediated neurodegenerative disease of the central nervous system, characterized by demyelination and varying degrees of axonal damage [1] . Depending on which neurological systems are affected and when, patients may experience a range of symptoms including fatigue, neuropsychiatric disturbances, motor, sensory, visual, cerebellar, and brainstem dysfunctions. Impairments in muscle strength, sensation, and balance contribute to postural instability and, consequently, increase the risk of falls. According to the literature, falls occur in approximately 54%–56% of people with MS (pwMS) [2] . Physiological factors linked to falls include higher disability levels, progressive disease course, assistive device usage, and impaired balance [3] . Notably, a consistent correlation between fall status and the Expanded Disability Status Scale (EDSS) has been observed only at intermediate EDSS levels (4.0–6.0) [4, 5] .  \nMost studies investigating falls in pwMS report mean EDSS scores greater than 3.0 [6–8] . However, even in the absence ","cbCaifUWY06zqPtc","https://ap.wps.com/l/cbCaifUWY06zqPtc","pdf",804333,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusion\n# Introduction\n## Multiple sclerosis and fall risk\n## Fear of falling and activity impact\n## Need for early screening and PROMs","[{\"question\":\"Who participated in the study and how was disability level defined?\",\"answer\":\"The study assessed fifty RRMS patients with EDSS \\u003c 4.0 (aged 18–50) and thirty age-, sex-, and education-matched healthy controls.\"},{\"question\":\"Which PROMs and assessments were used to evaluate fall and fear of falling risk?\",\"answer\":\"Participants reported fall history and were assessed with balance measures, gait speed via T25FW, walking limitations using MSWS-12, cognitive function (MoCA), depression (BDI-II), and fear of falling using FESI.\"},{\"question\":\"What were the main findings about falls and fear of falling in low-disability MS?\",\"answer\":\"Falls occurred in 48% of people with multiple sclerosis versus 30% of healthy controls, and fear of falling was significantly more common in the MS group. MS fallers had higher MSWS-12 and FES-I scores than non-fallers.\"}]","PROMs reveal early fall risk in the absence of clinical disability in people with multiple sclerosis | PDF",1790751338]