Fall Prevention Program for Multiple Sclerosis
January 22, 2015
Falls happen. Fall incidence can increase with disability. Falls in multiple sclerosis (MS) are common and often occur due to motor weakness, imbalance, gait impairment, and not using the adaptive equipment (cane, walker, orthotic) designed to help one ambulate more effectively and safely.
Falls can result in injury. This injury might only be an embarrassment to one’s pride; however, at other times, falls can contribute to more serious problems such as a fractured hip, a head injury, and in the worst case scenario, death. It is therefore important that we take a proactive approach to fall prevention.
The International Multiple Sclerosis Falls Prevention Research Network has examined the roles of various fall prevention rehabilitation programs to learn which might be the most effective in reducing fall risk and falls (click here to read the research). A critical element, in all programs, is that participant improvement in fall risk and fall reduction is primarily achieved in the short term but not sustained over the long term. The reality is that most people's motivation, to continue a program, dramatically "falls off" over time.
Here's a summary of the different types of program settings:
Each fall prevention program setting has its strengths and weaknesses. A review of the literature supports that there is little difference in initial program effectiveness (reduction in falls) between the settings; however, maintaining ongoing engagement is a key factor in achieving sustained behavior change.
Maintaining behavior change over the long term is the challenge confronting all fall prevention programs. However, programs that facilitate ongoing use of fall prevention strategies may offer the best long term benefits. Programs with a strong home based focus are much more convenient. However, unless these programs are created to include group interaction (tele-health or online facilities), they provide little opportunity for participants to learn from each other, motivate each other, obtain guidance from an instructor, or use exercise equipment. The most successful fall prevention programs of the future may combine the best features of each program in a mixed setting model.
The aim of any fall prevention program is to most therapeutically target that population's needs and desires for the present and future. With regard to MS, further research is needed that involves people, with MS, becoming involved in the decision making process for fall prevention programs.