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Free From Falls education and exercise program for reducing falls in people with multiple sclerosis: a randomized controlled trial
Cameron MH, Hildebrand A, Hugos CL, Judd GI, McMillan G, Jacobs PG
Multiple Sclerosis Journal 2022 May;28(6):980-988
clinical trial
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: No; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: People with multiple sclerosis (PwMS) fall frequently. Community-delivered exercise and education reduce falls in older adults, but their efficacy in multiple sclerosis (MS) is unknown. OBJECTIVES: To evaluate the impact of the Free From Falls (FFF) group education and exercise program on falls in PwMS. METHODS: This was a prospective, assessor-blinded, two-arm parallel randomized controlled trial. Ninety-six participants were randomized to FFF (eight weekly 2 hour sessions) or the control condition (a fall prevention brochure and informing their neurologist of their fall history). Participants counted falls prospectively from enrollment through 6 months following intervention. Effects on fall frequency were evaluated by the Bayesian analysis. RESULTS: The modeled mean fall frequency pre-intervention was 1.2 falls/month in the FFF group (95% credible intervals (CIs) 0.8 to 2.0) and 1.4 falls/month in the control group (95% CI 0.9 to 2.1). Fall frequency decreased by 0.6 falls/month in both groups over time (nadir 4 to 6 months post-intervention FFF 0.6 falls/month (95% CI 0.4 to 0.9); control 0.8 falls/month (95% CI 0.5 to 1.1)). CONCLUSION: In-person group exercise and education are not superior to written education and neurologist-initiated interventions for preventing falls in PwMS.

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