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�� Using a qualitative research approach, researchers found that study participants, despite reporting problems with balance and falls, did not wish to use walking aids or wheelchairs.55 They explained that using these devices had two drawbacks from their points of view: first, canes, Linsitinib manufacturer walkers, and wheelchairs were perceived as clear signs of disability that attracted sometimes unwanted attention from others; second, they considered the use of devices to be a sign of ��giving up�� or accommodating to MS. Participants felt that by using mobility aids, they would sacrifice potentially beneficial exercise effects of unaided (but often unsteady) walking on their balance and leg strength. Many participants described switching to a new gait aid reluctantly after a fall, sometimes at the insistence of concerned family members. Figure 1. Reasons for falls in multiple sclerosis change over time The Impact of Balance Problems Among Older People with MS It is intuitive to think that safety in balance and mobility and lack of falls are integral to healthy aging with MS. However, there is little research examining the relationship between falls, balance, and health learn more among older people with MS or people with higher degrees of MS-related disability. Grounded by qualitative findings, Ploughman and colleagues56 conducted the largest survey of health, lifestyle, and aging with MS in Canada. They recruited older people with MS (��55 years of age) with symptoms for at least 20 years. Through Canadian MS clinics, MS Society chapters, and newspapers, 921 people were contacted and 743 surveys were returned.56 Participants ranged in age from 55 to 88 years, with a mean (��SD) age of 64.6 (��6.2) years and a mean duration of MS symptoms of 32.9 (��9.5) years. Although the researchers did not specifically ask participants about falls, survey respondents were asked about the extent of their balance CGK 733 problems (29-item Multiple Sclerosis Impact Scale, Question 22),57 their independence in activities of daily living (Barthel Index),58 and health-related quality of life (visual analogue scale). Over 70% of the sample reported moderate to extreme problems with balance (Figure 2). Severity of balance problems was inversely correlated with Barthel Index score (Pearson correlation ?0.46, P