Comprehensive Fall Prevention and Detection in Multiple Sclerosis

Portland VA Medical Center96 enrolled

Overview

The purpose of this study is to examine whether an exercise and educational classroom program can help reduce falls in people with Multiple Sclerosis who fall frequently.

The investigators will recruit 94 people with Multiple Sclerosis, who report having fallen at least twice in the previous 2 months. Participants will be randomized to be placed in either a group that receives classroom training during the study, or into a wait-listed control group that will be offered the classroom training after their participation in the study is completed. All participants will receive mobility and quality of life assessments at baseline, 9 weeks, 5 months, and 8 months. All participants will be asked to record any falls they have on falls calendars. In addition, 30 participants will be randomized to wear electronic fall detectors on their bodies for the duration of the study. These detectors will record when and where falls occur, and this data will be compared with the participants' self-reported falls as recorded on the falls calendars.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

Conditions

Multiple Sclerosis

Interventions

Free From Falls fall prevention programBEHAVIORAL

Eight-week education and exercise program, intended to reduce falls in people with Multiple Sclerosis.

Electronic Fall DetectorOTHER

30 participants will be randomly selected to wear an electronic fall detector during the first 10 weeks of study participation. This fall detector will automatically record any falls occurring while worn.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Multiple Sclerosis of any type, * self-reported history of 2 or more falls in the previous 2 months, * Expanded Disability Status Scale of ≤ 6.0 (i.e. able to walk at least 100 meters with or without a walking aid), * be willing and intellectually able to understand and to sign an informed consent, and to adhere to protocol requirements, * have sufficient motor function to complete a written daily record of falls for 8 months, * be community dwelling. Exclusion Criteria: * have a self-reported musculoskeletal or neurological condition other than MS that is known to affect balance or gait and is associated with falls, such as a lower-extremity joint replacement within the past year, peripheral neuropathy, vestibular disorder, alcoholism, stroke, or seizures. * be unable to follow directions in English, * have unhealed bone fractures or other condition that may put them at risk of injury during balance training and assessments, * blind (visual acuity corrected worse than 20/200), * serious psychiatric or medical conditions that would preclude reliable participation in the study.

Locations (1)

VA Portland Health Care System

Portland, Oregon, United States

Outcomes

Primary Outcomes

Change from Baseline in Self-Reported Falls and Fall-Related Injuries at Completion of Program and the Following Six Months

Paper fall calendars

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Balance Confidence

Activities-specific Balance Confidence questionnaire

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Satisfaction with Participation in Social Roles

Patient Reported Outcomes Measurement Information System (PROMIS) Item Bank v. 1.0 - Satisfaction with Participation in Social Roles

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Ability to Participate in Social Roles and Activities

Patient Reported Outcomes Measurement Information System (PROMIS) Item Bank v. 2.0 - Ability to Participate in Social Roles and Activities

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Quality of Life

Multiple Sclerosis Impact Scale-29

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Accuracy and Impact of Fall Detection and Localization by the MobileRF Fall Detection System, Compared to Paper Fall Calendars

The Mobile RF Fall Detection System automatically records falls per day experienced by the wearer. The results obtained by the fall detector will be tested for accuracy against the self-reported falls reported on paper fall calendars, in which participants manually record falls per day on a paper log.

Data from ClinicalTrials.gov

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Secondary Outcomes

Change from Baseline in Mobility and Balance (TUG score) at Completion of Program and the Following Six Months

Timed Up and Go

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Mobility and Balance (FSST score) at Completion of Program and the Following Six Months

Four Square Step Test

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Level of Physical Activity at Completion of Program and the Following Six Months

International Physical Activity Questionnaire, short form

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months from baseline), 6 months after program completion (9 weeks + 6 months + baseline)

Change from Baseline in Fall Prevention Strategy at Completion of Program and the Following Six Months

Fall Prevention Strategy Survey

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Fatigue at Completion of Program and the Following Six Months

Patient Reported Outcomes Measurement Information System (PROMIS) Item Bank v. 1.0 - Fatigue

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Mobility at Completion of Program and the Following Six Months

Patient Reported Outcomes Measurement Information System (PROMIS) Item Bank v. 1.2 - Physical Function - Mobility

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Psychosocial Function at Completion of Program and the Following Six Months

Patient Reported Outcomes Measurement Information System (PROMIS) Item Bank v. 1.0 - Psychosocial Illness Impact - Positive

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)

Change from Baseline in Knowledge and Confidence Regarding Fall Prevention at Completion of Program and the Following Six Months

Fall Prevention Knowledge and Confidence Questionnaire

Time frame: At baseline, at program completion (9 weeks), 3 months after program completion (9 weeks + 3 months), 6 months after program completion (9 weeks + 6 months)