Fall risk and incidence reduction in high risk individuals with multiple sclerosis: a pilot randomized control trial

Jacob J Sosnoff; Yaejin Moon; Douglas A Wajda; Marcia L Finlayson; Edward McAuley; Elizabeth W Peterson; Steve Morrison; Robert W Motl

doi:10.1177/0269215514564899

Fall risk and incidence reduction in high risk individuals with multiple sclerosis: a pilot randomized control trial

Clin Rehabil. 2015 Oct;29(10):952-60. doi: 10.1177/0269215514564899. Epub 2014 Dec 23.

Authors

Jacob J Sosnoff¹, Yaejin Moon², Douglas A Wajda², Marcia L Finlayson³, Edward McAuley², Elizabeth W Peterson⁴, Steve Morrison⁵, Robert W Motl²

Affiliations

¹ Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, IL, USA jsosnoff@illinois.edu.
² Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, IL, USA.
³ School of Rehabilitation Therapy, Queens University, Kingston, ON, Canada.
⁴ Department of Occupational Therapy, University of Illinois at Chicago, Urbana, IL, USA.
⁵ School of Physical Therapy and Athletic Training, Old Dominion University, Norfolk, VA, USA.

PMID: 25540170
DOI: 10.1177/0269215514564899

Abstract

Objective: To determine the feasibility of three fall prevention programs delivered over 12 weeks among individuals with multiple sclerosis: (A) a home-based exercise program targeting physiological risk factors; (B) an educational program targeting behavioral risk factors; and (C) a combined exercise-and-education program targeting both factors.

Design: Randomized controlled trial.

Setting: Home-based training with assessments at research laboratory.

Participants: A total of 103 individuals inquired about the investigation. After screening, 37 individuals with multiple sclerosis who had fallen in the last year and ranged in age from 45-75 years volunteered for the investigation. A total of 34 participants completed postassessment following the 12-week intervention.

Intervention: Participants were randomly assigned into one of four conditions: (1) wait-list control (n = 9); (2) home-based exercise (n = 11); (3) education (n = 9); or (4) a combined exercise and education (n = 8) group.

Measures: Before and after the 12-week interventions, participants underwent a fall risk assessment as determined by the physiological profile assessment and provided information on their fall prevention behaviors as indexed by the Falls Prevention Strategy Survey. Participants completed falls diaries during the three-months postintervention.

Results: A total of 34 participants completed postintervention testing. Procedures and processes were found to be feasible. Overall, fall risk scores were lower in the exercise groups (1.15 SD 1.31) compared with the non-exercise groups (2.04 SD 1.04) following the intervention (p < 0.01). There was no group difference in fall prevention behaviors (p > 0.05).

Conclusions: Further examination of home-based exercise/education programs for reducing falls in individuals with multiple sclerosis is warranted. A total of 108 participants would be needed in a larger randomized controlled trial.ClinicalTrials.org #NCT01956227.

Keywords: Multiple sclerosis; accidental falls; balance; education; fall risk factors; gait; mobility.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls / prevention & control*
Accidental Falls / statistics & numerical data
Aged
Exercise Therapy / methods*
Feasibility Studies
Female
Home Care Services
Humans
Incidence
Male
Middle Aged
Multiple Sclerosis / complications
Multiple Sclerosis / rehabilitation*
Outcome and Process Assessment, Health Care / statistics & numerical data
Patient Education as Topic*
Pilot Projects
Risk Assessment

Associated data

ClinicalTrials.gov/NCT01956227

Grants and funding

TL1 TR002368/TR/NCATS NIH HHS/United States