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Are falls in people with multiple sclerosis related to the severity of urinary disorders? - 29/07/21

Doi : 10.1016/j.rehab.2020.10.006 
Claire Hentzen , Anaïs Villaumé, Nicolas Turmel, Camille Chesnel, Frédérique Le Breton, Rebecca Haddad, Gérard Amarenco
 GRC 001, GREEN Groupe de recherche clinique en neuro-urologie, hôpital Tenon, Sorbonne Université, AP–HP, 75020 Paris, France 

Corresponding author at: Service de neuro-urologie, 4, rue de la Chine, 75020 Paris, France.Service de neuro-urologie4, rue de la ChineParis75020France

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Highlights

Among 154 patients with multiple sclerosis and urinary disorders (UDs), 63 reported 1 or more falls during the past 3 months, 9 on the way to the bathroom.
No link was found between falls during the past 3 months and severity of UDs.
Overactive bladder and nocturia were linked with falls on the way to the bathroom.
A high 12-Item Multiple Sclerosis Walking Scale score and a high Time to be Ready to Void test score were associated with falls.

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Abstract

Background

Lower urinary tract symptoms (LUTSs), especially overactive bladder, are frequent in people with multiple sclerosis (PwMS). Urinary urgency and urge urinary incontinence could lead to precipitation and thus could increase the risk of falling in these individuals.

Objective

We aimed to assess the association between severity of LUTSs and risk of falling in PwMS.

Methods

PwMS with LUTSs were recruited in a neuro-urology department. Participants were asked about the number of falls in the past 3 months and their circumstances. Severity of LUTSs was assessed by the Urinary Symptoms Profile (USP) score, and individuals were classified as with or without urinary incontinence.

Results

This cross-sectional study included 154 patients (69% women); the mean (SD) age was 50.1 (11.5) years and median EDSS was 5 (interquartile range 3–6). Overall, 20 (13%) patients reported one fall during the past 3 months, and 43 (28%) reported at least 2 falls. Only 9 (6%) patients reported a fall on the way to the toilet, 6 during a urinary urgency. No link was found between falls and urinary incontinence (P=0.71), type or severity of urinary symptoms (overactivity, voiding dysfunction or stress incontinence, P>0.05). Falls on the way to the bathroom was associated with high USP score related to overactive bladder (P=0.03) and severe nocturia (>2 nocturnal micturitions) (P<0.01). Falling at night was also associated with severe nocturia (P<0.001).

Conclusions

The severity of LUTSs and presence of urinary incontinence do not appear related to the risk of falling in PwMS and urinary disorders but rather to the specific risk of falling on the way to the bathroom. Severe nocturia increases the risk of falling at night. Further studies are needed to assess the impact of LUTS treatment on the risk of falling. ClinicalTrials.gov (NCT04338646).

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Fall, Multiple sclerosis, Lower urinary tract symptoms, Overactive bladder


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Vol 64 - N° 4

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