Date Presented 04/22/2023
A preintervention–postintervention study to evaluate iROLL-O, an online fall prevention intervention for people with multiple sclerosis who use a wheelchair or scooter, is described. Findings advance evidence-based fall prevention practice.
Primary Author and Speaker: Toni Van Denend
Additional Authors and Speakers: Amy McArthur
Contributing Authors: Elizabeth Walker Peterson, Deborah Backus, Jacob Sosnoff, Libak Abou, Arman Sandhu, Laura Rice
PURPOSE: To evaluate the efficacy of iROLL-O, a group-based, online, fall prevention intervention designed for people with multiple sclerosis (PwMS) who use a wheelchair or scooter (WC/S) that features self-management content. The paucity of evidence-based, accessible interventions for this unique population that can be delivered by occupational or physical therapists created the imperative for this study.
DESIGN: A pre/post intervention, longitudinal experimental study was utilized. Participants were recruited primarily from North American Research Committee on MS Registry. All had MS, >18 years old, and had a Patient Determined Disease Steps Score of 7.
METHOD: Fall prevalence data, gathered via a fall tracking log, was recorded 12 weeks prior to and 32 weeks post-intervention (44 weeks total). Assessment of other key dependent variables occurred 12-weeks prior to the start of IROLL-O, immediately post- and 32 weeks post-intervention. These variables included fear of falling (SCI-Falls Concern Scale); knowledge related to fall prevention/management (Fall Prevention/Management Questionnaire); and fall management (Fall Management Scale). Repeated measures one-way ANOVA evaluated the intervention effect over time. An LSD Post-Hoc test determined differences between timepoints. Cohen’s d effect sizes were estimated.
RESULTS: 12 participants completed the intervention. No significant change in fall incidence occurred. Fear of falling was significantly reduced following iROLL-O as measured by SCI-FCS scores (p<0.01, η2=0.47, d=0.80). Significant improvement in both FMS (p=0.04, η2=0.26, d=0.85) and FPMQ (p=0.03, η2=0.36, d=0.67) scores was observed.
CONCLUSION: iROLL-O has promise in achieving desired outcomes.
IMPACT STATEMENT: This study is first to evaluate the impact of an online fall prevention intervention for PwMS who use WC/S and will inform development of fall prevention programs for this vulnerable population.
References
Rice, L. A., Yarnot, R., Sung, J., Sosnoff, J. J., Backus, D., Abou, L., Shen, S., & Peterson, E. W. (2022). Pilot Study of a Fall Prevention and Management Intervention Program for People With Multiple Sclerosis Who Use a Wheelchair or Scooter Full-Time. Archives of Rehabilitation Research and Clinical Translation, 100225. https://doi.org/https://doi.org/10.1016/j.arrct.2022.100225
Rice, L. A., Peterson, E. W., Backus, D., Sung, J., Yarnot, R., Abou, L., Van Denend, T., Shen, S., & Sosnoff, J. J. (2019). Validation of an individualized reduction of falls intervention program among wheelchair and scooter users with multiple sclerosis. Medicine (Baltimore), 98(19), e15418. https://doi.org/10.1097/md.0000000000015418
Rice, L., Kalron, A., Berkowitz, S. H., Backus, D., & Sosnoff, J. J. (2017). Fall prevalence in people with multiple sclerosis who use wheelchairs and scooters. Medicine (Baltimore), 96(35), e7860. https://doi.org/10.1097/md.0000000000007860
McArthur, A., Peterson, E., Sosnoff, J., et al. (In review). Online delivery of the individualized reduction of falls intervention for people with multiple sclerosis who use a wheelchair or scooter full-time: A pilot study. International Journal of MS Care.
