Accidental Fall, Gait Disorders, Neurologic, Multiple Sclerosis
Conditions
Keywords
Backward Walking, Neurorehabilitation
Brief summary
Individuals with multiple sclerosis (MS) experience in impairments in mobility and cognition that increase the risk for accidental falls. More than 50% of individuals with MS experience injurious falls within a 6-month period. Current interventions to improve fall risk have focused on forward walking (FW) and balance training, resulting in small declines in the relative risk for falls with a large degree of variability. Interestingly, motor differences between MS and healthy controls are more pronounced in backward walking (BW), yet no studies have investigated BW training as an intervention to reduce fall risk in persons with MS. This study will investigate the feasibility, acceptability and impact of BW training compared to forward walking training on motor function and fall risk in persons with MS.
Interventions
BEHAVIORALBackward Walking Training
Training will consist of BW training on both a treadmill and overground. All participants will receive 1x/week training with a trained member of the research team, who will progress the participant week-to-week and ensure safety. Treadmill speed will be determined by baseline BW walking speed and incrementally increased with each training week to subject tolerance. Participants will follow a home exercise program for the remainder of the week that includes BW, backward stepping, and functional exercises that incorporate BW movements.
BEHAVIORALForward Walking Training
Training will consist of FW training on both treadmill and overground. All participants will receive 1x/week training with a trained member of the research team, who will progress the participant week-to-week and ensure safety. Treadmill speed will be determined by baseline FW walking speed and incrementally increased with each training week to subject tolerance. Participants will follow a home exercise program for the remainder of the week that includes FW, forward stepping, and functional exercises that incorporate FW movements.
Sponsors
Wayne State University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Diagnosis of MS * PDDS \<6, indicating ability to ambulate with or without an assistive device \>/= 50% of the time * Self-reported walking dysfunction as evidenced by a score of \>/= 30 on MSWS-12 OR reports of 2 or more falls in the prior 6 months, indicating a frequent faller.
Exclusion criteria
* MS relapse within the past 30 days * comorbid neurological disorder * acute orthopedic disorder/injury * unable to follow study-related commands
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Sway during quiet stance | Change in sway at 8 weeks | Measured with APDM Sensors |
| Stepping latency on push-and-release test | Change in stepping latency at 8 weeks | Measured with APDM Sensors |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Client Satisfaction Questionnaire (CSQ-8) | 8 weeks | Scores range from 8-32, with high scores indicating greater satisfaction with the intervention |
| Patient Global Impression of Change | 8 weeks | Perceived Treatment Effect; scores range from 1-7 with higher scores indicating greater perception of improvement related to the intervention. |
| Number of Active Minutes | Change in Physical Activity measures at 8 weeks | Measured with Accelerometry, passively collected for a 1 week period prior to the intervention and again after the intervention concludes 8 weeks later. |
| Number of Falls | 6 months | Number of falls reported in 6 month period after the intervention ends |
| Forward and Backward Velocity and Double Support Time | Change in velocity and double support time at 8 weeks | Walking speed and double support time (spatiotemporal measures of gait) |
| ABC Scale | Change in balance confidence at 8 weeks | Balance confidence |
Countries
United States
Contacts
PRINCIPAL_INVESTIGATORNora Fritz, PhD
Wayne State University
Outcome results
None listed