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

Online Delivery of the Individualized Reduction of Falls Intervention for Persons With Multiple Sclerosis Who Use a Wheelchair or Scooter Full-time: A Pilot Study

“…[2][3][4] As a result, an evidence-based fall prevention and management intervention program designed specifically for people with MS who use a WC/S full-time is needed to promote the health and well-being of this population. 5 To address this need, from June 2018 to March 2020, Rice et al 6 conducted an in-person fall prevention and management intervention, Individualized Reduction of Falls-In Person (iROLL-IP), designed specifically for people with MS using a WC/S full-time. The intervention was created and evaluated by an interprofessional team of physical therapists and occupational therapists.…”

“…Results from the delivery of the iROLL-IP intervention revealed significant improvements in participant reports of fall management strategies, community participation, and transfer quality. 6 Emergence of the COVID-19 pandemic in early 2020 combined with findings from a process evaluation that highlighted access-related challenges to study participation necessitated the transition of iROLL-IP from face-to-face to remote delivery. In addition to removing access barriers related to travel, online delivery allowed for recruitment from communities without access to large health care or research institutions, such as rural populations.…”

“…Next, participants completed a series of online assessments, as follows, using REDCap. All assessments, unless otherwise noted, have been validated for use among people with MS. Additional details regarding the outcome assessments are noted by Rice et al 6 • Fear of falling was evaluated using the Spinal Cord Injury-Falls Concern Scale 8 ; higher scores indicate greater concern. Although the scale has been validated only among individuals living with spinal cord injuries, it evaluates FOF while performing a variety of activities that are applicable to many individuals who use a WC/S and has been used successfully in previous studies that included participants living with MS. 9…”

A process evaluation of an on-line fall prevention and management program for individuals who use wheelchairs or scooters living with multiple sclerosis

“…Findings from the multi-site clinical trial undertaken to evaluate the efficacy of the iROLL-IP intervention demonstrated that 3 months after completion of the intervention, iROLL-IP participants demonstrated significant improvements in knowledge of fall prevention strategies ( p = 0.01), knowledge of fall management strategies ( p = 0.01), community participation in activities important to the participant ( p ≤ 0.01), and transfer quality ( p = 0.002). No significant differences were seen related to fall frequency, quality of life, seated postural control, or wheelchair skills ( 15 ). Process evaluation findings indicated iROLL-IP was implemented with high fidelity and that participants were highly satisfied with the intervention.…”

“…Individualized Reduction of FaLLs-In Person includes concise didactic instruction on these topics, as well as exercises to improve sitting balance and core strength, and content designed to build wheelchair/scooter and transfer skills. Post-fall recovery and use of assistive technologies is highlighted in the intervention ( 15 ). Individualized Reduction of FaLLs trainers use a variety of educational strategies to actively engage participants ranging from group discussions, physical demonstrations, and practice opportunities.…”