Pilot Study of a Fall Prevention and Management Intervention Program for People With Multiple Sclerosis Who Use a Wheelchair or Scooter Full-Time

Examine the efficacy of a fall prevention/management intervention among people with multiple sclerosis (PwMS) who use a wheelchair or scooter (WC/S) full-time. Pre-post/follow-up trial Community and research laboratory Twenty-one PwMS who used a WC/S full-time, self-reported at least 1 fall /12 months, and could transfer independently or with minimal/moderate assistance. Six-week, group and community-based fall prevention and management intervention. The intervention included six, 2-hour, in-person, weekly sessions led by a physical or occupational therapist featuring interactive group discussions, skill practice, and action planning opportunities. Fall frequency tracked 12 weeks pre and 24 weeks post intervention. Outcomes were assessed pre- and post-intervention and 12-weeks post-intervention. Measures included surveys to examine fear of falling, fall prevention/management, quality of life, and community participation and assessment of functional mobility skills. Semi-structured interviews were administered post-intervention to ascertain overall experiences with the program and impact on daily life. A Friedman test, with signed-rank post-hoc analysis was run to determine differences across the three study visits. After the intervention, fall incidence did not significantly change, but fall management strategies (p=0.01-0.05), importance of community participation (p=0.01), and transfer quality (p= 0.02) significantly improved. Moderate effect sizes were noted among concerns about falling, activity curtailment due to FOF, and wheelchair skills. Qualitative results indicate that participants found the intervention beneficial and applied intervention content in their daily lives. This study is the first to describe the impact of a multi-component fall prevention/management intervention designed specifically for PwMS who use WC/S full-time. Results indicate the program has potential to reduce fall risk however further testing is needed to fully examine the impact of the program.