Free from Falls Program at the University of South Florida

Background:

Over the course of 8 weeks, the National Multiple Sclerosis Society’s (NMSS) “Free from Falls” curriculum increases knowledge about fall prevention and strategies to decrease risk of falling. Each week’s 2-hour program has two parts; a discussion component focused on the awareness of issues related to falls and an exercise component directed at improving postural alignment, balance, endurance, and mobility. We implemented this program at the University of South Florida (USF) School of Physical Therapy & Rehabilitation Sciences (SPTRS). Two Doctor of Physical Therapy (DPT) students who are also USF MS STEP UP Scholars led the program. The MS STEP UP is a collaboration between USF SPTRS and the NMSS Mid Florida Chapter to train DPT students with advanced knowledge and skills in treating people with MS.

Objectives:

Objectives of the NMSS “Free from Falls” program are to assist people with MS to:

• Understand the functional role of exercise in reducing the risk of falls
• Explore fears about falling and recognize how these affect behaviors in everyday living
• Practice strategies that help shift attitudes and behaviors caused by fears in a way that will enhance self-efficacy when dealing with falling
• Practice center of gravity and postural control training
• Understand types of equipment that can enhance mobility and indications or barriers for each.
• Learn stretching exercises to help manage spasticity and improve flexibility/mobility
• Recognize how fatigue can affect falling and learn techniques to manage fatigue
• Identify potential environmental hazards that may contribute to falls
• Integrate exercises into daily routine, and develop an ongoing home exercise program to maximize balance and mobility
• Learn the Stop, Scan, and Plan technique to identify and navigate fall risks
• Understand how to get up from the floor safely if a fall occurs

Methods:

Five participants with MS completed this 8 week program led by two physical therapy students and supervised by USF faculty.

Results:

The majority of participants demonstrated both objective and subjective improvement after completing the 8 week program. Objective improvement was observed by cumulative increases in both the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test scores. Subjective improvements were also noted in the Activities-Specific Balance Confidence (ABC) scale. 

Conclusions:

During the program, participants became more aware of the prevalence of falls among those with MS and risk factors that contribute to falls. They learned strategies to prevent falls and how to develop a fall prevention plan. Participants increased their confidence in minimizing fall risk and in managing falls if they do occur. Additional community resources to implement fall prevention action plans were provided. Equipped with the knowledge gained during this program, our hope is that the participants will engage in, and develop a home fitness plan that addresses balance, endurance, and strength, aimed at reducing falls.