Interventions for preventing falls in people with multiple sclerosis

Hayes, Sara; Galvin, Rose; Kennedy, Catriona; Finlayson, Marcia; McGuigan, Christopher; Walsh, Cathal; Coote, Susan

doi:10.1002/14651858.cd012475.pub2

Cited by 38 publications

(44 citation statements)

References 70 publications

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“…Two systematic reviews of interventions to reduce falls exist. 72,73 Sosnoff and Sung (2015) identified 10 studies, four were randomised controlled trials with a total of 524 participants. The increased focus on this topic resulted in 13 RCT's being included in the recently published Cochrane review.…”

Section: Treatmentmentioning

confidence: 99%

“…The increased focus on this topic resulted in 13 RCT's being included in the recently published Cochrane review. 73 In contrast, a systematic review of exercise interventions for falls prevention in older adults included 108 RCTs with 23,407 participants living in the community in 25 countries. 74 The majority of MS studies with exercise interventions included conventional balance, sensory-specific and game-based exercises.…”

Section: Treatmentmentioning

confidence: 99%

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Falls in People with Multiple Sclerosis

Coote¹,

Comber²,

Quinn³

et al. 2020

International Journal of MS Care

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Falls are highly prevalent for people with Multiple Sclerosis (MS) and result in a range of negative consequences such as injury, activity curtailment, reduced quality of life, increased need for care and time off work. This narrative review aims to summarise key literature and to discuss future work needed in the area of falls prevention for people with MS. The incidence of falls is estimated to be over 50%; similar to the rate of falls in adults over 80 years. The consequences of falls are considerable as rate of injury is high, and fear of falling and low self-efficacy are significant problems that lead to activity curtailment. A wide range of physiological, personal and environmental factors have been highlighted as potential risk factors and predictors of falls. Falls are individual and multifactorial, and hence approaches to interventions will likely need to adopt a multi-factorial approach. However, the literature to date has largely focused on exercise-based interventions, with newer more comprehensive interventions using both education and exercise showing promising results. Several gaps remain in the topic of falls in MS and in particular the lack of standardisation of definitions and outcome measures to enable data pooling and comparison. In future, the involvement of people with MS in the design and evaluation of programmes is essential, as are approaches to intervention development that consider implementation from the outset.

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Section: Treatmentmentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

Falls in People with Multiple Sclerosis

Coote¹,

Comber²,

Quinn³

et al. 2020

International Journal of MS Care

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“…All the dentifrices except MPO were measured to have a lower concentration of bioavailable F than their respective total F concentration, hence the null hypothesis was rejected. With the exception of the MPO dentifrice, all dentifrices were observed to have bioavailable F concentrations below 1000 ppm, the concentration deemed significant for caries prevention in permanent teeth 32 , 33 . In addition to having the highest absolute bioavailable F, the MPO dentifrice had approximately 97% bioavailable/total F, indicating the MPO formulation promoted release of soluble F and the stated F level on the label was an accurate reflection of the dentifrice’s bioavailable F. The relatively low bioavailable F and percent bioavailable/total F observed in the remaining dentifrices may be explained by the type of F and calcium compound in their respective formulations.…”

Section: Discussionmentioning

confidence: 97%

Bioavailable fluoride in calcium-containing dentifrices

Shen

Fernando

Yuan

et al. 2021

Sci Rep

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Calcium added to dentifrices can complex with fluoride ions to reduce intra-oral bioavailability and therefore efficacy in preventing dental caries. Six commercially available dentifrices containing different types of calcium and fluoride were analyzed for total and bioavailable fluoride levels by adding 10 g of dentifrice to 30 mL of distilled deionized water and mixing vigorously for 1 min to simulate toothbrushing. One milliliter of the dentifrice/water slurry was immediately centrifuged and the supernatant removed for bioavailable fluoride analysis and the mixed slurry prior to centrifugation used for total fluoride analysis using a modified microdiffusion method. The concentration of fluoride was determined using a fluoride ion-selective electrode calibrated with internal fluoride standards. All the dentifrices had similar total fluoride concentrations to those indicated on their labels (94% to 105%). However, only one dentifrice that contained calcium in the form of casein phosphopeptide amorphous calcium phosphate (CPP-ACP) had almost 100% (97%) of fluoride in bioavailable form. The other dentifrices contained calcium carbonate and they exhibited significantly (p < 0.001) lower bioavailable fluoride levels (27% to 61%), through the generation of poorly soluble fluoride phases. The saliva biomimetic CPP, as CPP-ACP, in a dentifrice stabilised calcium and fluoride ions to maintain fluoride’s bioavailability.

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“…If the patient had been provided with such an exercise program, and strategies for adherence and motivation, he would have been able to perform physical exercises during the COVID-19-related lockdown to stop or slow down his functional decline. Several structured home-based exercise programs for people with PD or MS have been developed [32,33]. The effectiveness of these different programs on physical functional and mobility related outcomes varies, but we are convinced that home-based exercise programs should be prescribed for people with chronic neurological conditions to support self-care and to improve functional abilities [34].…”

Section: Strengths and Limitations Of The Management Of This Casementioning

confidence: 99%

The impact of a COVID-19 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report

Braun

Weidmann

Ammann

et al. 2020

Preprint

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Background: Regular outpatient rehabilitation is prescribed for many patients with chronic neurological disorders, such as Parkinson's disease or Multiple Sclerosis, to constantly support patients and their proxies in disease management. Due to the COVID-19 pandemic, federal institutions and governments worldwide have directed local or nationwide lockdowns. During these times, the provision of regular outpatient rehabilitation service is drastically limited, making it actually impossible for community-dwelling patients with neurological disorders to receive prescribed rehabilitation interventions.Case presentation: A 67-year-old man with two chronic neurological diseases, Parkinson's disease and Multiple Sclerosis, underwent a 4-week inpatient rehabilitation in our hospital. The patient gained significant functional improvements that he maintained over the following months, supported by the continuation of physiotherapy in the domestic environment. Due to a COVID-19 pandemic related interruption of the regular ambulatory rehabilitation for several weeks, the patient’s functional abilities decreased significantly. Thus, the patient was again referred to our hospital for intensive inpatient rehabilitation to regain his physical functioning and mobility capacity. At hospital discharge, the patient improved most of his physical functioning to a pre-pandemic level.Conclusions: The interruption of a rehabilitation service due to a pandemic-related lockdown can significantly impact the functional abilities of patients with chronic neurological diseases. This case report supports the claim for continuous access to rehabilitation services for all people with rehabilitation needs.

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Interventions for preventing falls in people with multiple sclerosis

Cited by 38 publications

References 70 publications

Falls in People with Multiple Sclerosis

Falls in People with Multiple Sclerosis

Bioavailable fluoride in calcium-containing dentifrices

The impact of a COVID-19 pandemic-related interruption of regular physical rehabilitation on functional abilities in a patient with two chronic neurological diseases: a case report

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