Feasibility and outcome of the fewer falls in multiple sclerosis intervention: a pilot randomized controlled trial

Falls are common among people with multiple sclerosis (PwMS) and bring risk of both injury and reduced quality of life. The multifactorial background to risk of falls necessitates adapted and comprehensive interventions. The "Fewer Falls in MS" intervention is a manualized online self-management fall prevention programme designed for both ambulatory and non-ambulatory PwMS. We conducted a pilot trial to evaluate feasibility and outcome of the Fewer Falls in MS to determine whether to advance to a full-scale randomized controlled trial (RCT). In this two-armed parallel group study, 46 adult PwMS from across Sweden were randomized to the intervention (n = 23) or control (n = 23) group. The intervention included six 2-hour weekly online group sessions led by a trained group leader, followed by a booster session 8 weeks later. Both groups received a brochure on fall prevention. Falls were monitored weekly for 18 weeks via SMS. The evaluation demonstrates that participant recruitment and retention, data collection, intervention delivery, session adherence, and outcome measures were feasible. At the 18 weeks follow-up, results from the standardized questionnaires and falls data revealed no significant between-group differences. Furthermore, no adverse events were reported. Meeting all, but one, progression criteria justify proceeding to a full-scale RCT, with insights from this pilot trial being used to further refine the intervention and outcome measures.