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

Objective: To determine the feasibility of three fall prevention programs delivered over 12weeks 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 45-75years 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.