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Area of Science:

  • Neurology
  • Rehabilitation Science
  • Digital Health

Background:

  • Falls are a significant concern for individuals with multiple sclerosis (MS), lacking a standard fall prevention protocol.
  • The in-person Free from Falls (FFF) program improved mobility, balance, and reduced falls in MS, but faced accessibility limitations.
  • Free from Falls Online (FFFO) was developed to overcome attendance barriers of the traditional FFF program.

Purpose of the Study:

  • To evaluate the effectiveness and user experience of an online, web-based fall prevention program (FFFO) for people with MS.
  • To determine if FFFO can reduce fall incidence compared to a control group.
  • To assess the feasibility of delivering self-management strategies for fall prevention via an online platform in MS.

Main Methods:

  • A randomized controlled trial involving 30 individuals with MS who had experienced at least two falls in the preceding two months.
  • Participants were assigned to either the eight-week FFFO program (instructional and exercise components) or a control group receiving fall risk minimization information.
  • Outcomes included prospective fall reporting over eight weeks and three months post-intervention, alongside a satisfaction survey for the FFFO group. Regression models analyzed fall incidence.

Main Results:

  • While regression models indicated a trend towards fewer falls in the FFFO group, statistical significance was only met in a post hoc analysis (p=0.0038).
  • The observed reduction in falls was most pronounced in the first month and diminished over subsequent months, not showing sustained effects at three months post-intervention.
  • User satisfaction with FFFO was high, with over 75% finding it easy to learn and use, and a majority finding the content and exercises useful.

Conclusions:

  • The study demonstrates the viability of online delivery for self-management strategies in MS fall prevention.
  • FFFO shows promise in helping to prevent falls among individuals with MS.
  • Preliminary data suggest the need for a fully powered randomized controlled trial to confirm FFFO's efficacy.