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Falls and spinal muscular atrophy: Exploring cause and prevention

Authors

  • Jacqueline Montes PT, MA,

    Corresponding author
    1. Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York 10032, USA
    • Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York 10032, USA

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  • Tara L. Mcisaac PT, PhD,

    1. Biobehavioral Sciences Department, Teachers College, Columbia University, New York, New York, USA
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  • Sally Dunaway PT, DPT,

    1. Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York 10032, USA
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  • Shirit Kamil-Rosenberg MS,

    1. Biobehavioral Sciences Department, Teachers College, Columbia University, New York, New York, USA
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  • Douglas Sproule MD,

    1. Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York 10032, USA
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  • Carol Ewing Garber PhD,

    1. Biobehavioral Sciences Department, Teachers College, Columbia University, New York, New York, USA
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  • Darryl C. De vivo MD,

    1. Department of Neurology, Columbia University Medical Center, 180 Ft. Washington Avenue, Fifth Floor, New York, New York 10032, USA
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  • Ashwini K. Rao OTR, EdD

    1. Department of Rehabilitation and Regenerative Medicine, Columbia University Medical Center, New York, New York, USA
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Abstract

Introduction: Falls can cause injury and may compromise function in spinal muscular atrophy (SMA) patients. Weakness and gait variability are associated with falls in other neurological disorders, and fatigue is well documented in SMA. The relationship of weakness, fatigue, and gait variability to falls has never been investigated. Methods: Seven ambulatory patients with SMA completed a falls history questionnaire, 6MWT, gait analysis, and strength testing. Pearson correlation coefficients were used to examine associations between these variables. Results: All 7 subjects reported falls in the previous year. Stride-length variability was significantly associated with falls, unlike strength, fatigue, or other gait variables. Conclusions: Stride-length variability was the key variable associated with falls. Preventive strategies to avoid falls should be incorporated into patient management plans. Gait analysis provides actionable information not revealed by standard assessments and should be included in clinical trials designed to address the prevention of falls in the SMA population. Muscle Nerve, 2013

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