Examination of "Free From Falls": An MS Society Comprehensive Fall Prevention Program

Background: Fall-induced injuries have commonly been recognized as a serious health concern in older adults, however also at risk are individuals diagnosed with a chronic illness such as Multiple Sclerosis (MS). Specifically, fall incidence for Persons with MS (PwMS) range from 50 - 64% in the past year (e.g., Cattaneo et al., 2002) with injuries being associated with loss of independence and increased use of health care services. PwMS who have suffered a fall report increased risk of future falling, loss of confidence, social isolation and significant curtailment of activities (Finlayson et al., 2010).

Objectives: Raise awareness of fall risks, provide strategies for minimizing risk, provide a fitness program to enhance balance and mobility for ambulatory PwMS.

Methods: The National MS Society developed the Free from Falls(FFF) curriculum--an 8 week, 2 hours/week program for ambulatory PwMS. National MS Society chapters piloted the program at over 20 sites across the US.

Results: The baseline sample shows the majority of participants are over 45 years of age (86%) and (77%) women. 69% of participants had fallen in the last 6-months with 71% reporting curtailment of activities. Participants completed an 8-week (2 hr/wk) program consisting of fitness and learning/awareness components. Repeated measures ANOVA were run comparing baseline scores with post-treatment scores with additional analyses comparing pre to 6-month follow-up. FFF participants showed significant improvement in balance, gait and psychological impact of falls. Significant improvements occurred in the  Berg Balance Scale, F (1,76) = 64.86, p < .05, Eta² = .46, from pre (M = 47.30; SD = 7.30) to post (M = 51.06; SD = 5.29);  the ‘8 Foot Timed Up and Go Test’ F (1,89) = 12.45, p < .05, Eta²= .12, from pre (M = 11.54; SD = 5.72) to post (M = 10.59; SD = 5.27); the  Activities-specific and Balance Confidence Scale (p < .05); and fall prevention Confidence  (p < .05). Impact was sustained at 6-months post as analyses revealed significant improvement in confidence and concern regarding falls (p < .05), decrease in activity curtailment due to fear of falling (p < .05), and use of strategies learned.

Conclusions: FFF is one of few MS-specific comprehensive fall-prevention programs being offered across the country for ambulatory PwMS. Results provide evidence of program success in physiological and satisfaction outcomes with qualitative feedback of gaining benefit from group support. Complete elimination of falls is unrealistic; however by completing the FFF program, participants received significant improvements in fall-related outcomes with impacts in physical and mental health.