The Better Balance Programme
Many people with multiple sclerosis experience falls, which can have significant consequences for the individual. The MS Research Team at the University of Limerick, led by Professor Susan Coote, have developed a programme, 'Better Balance', for people with multiple sclerosis and we would like to assess how suitable and effective the programme is.
What is involved?
‘Better Balance’ is specifically designed for people with MS who have had a recent fall and who use at most a walking stick or one crutch to walk ten metres. The programme begins with assessing falls rate through documenting whether or not they have a fall for two-months using falls diaries. Their balance, walking and feelings about falls are then assessed by a physiotherapist. The 12 week programme then begins and is multicomponent meaning that it involves both exercise and education. Exercises are designed and tailored for each and aim to challenge and train an individual’s balance. These exercises are then delivered in group exercise classes and through home exercise programmes. Education classes are delivered in groups and include education regarding known risk factors for falls and encourage the use of group brainstorming and problem solving through coaching strategies in order to equip people with MS with management strategies to manage their falls and falls risk. Overall ‘Better Balance’ aims to reduce falls and falls risk while providing pwMS with falls management strategies to use in their daily lives. Upon completion of the programme, each individual then completes another two months of falls diaries and is again assessed by a physiotherapist to see if the programme has reduced their falls and/or their falls risk.
The “Better Balance” programme consists of 12 weeks of twice-weekly classes run by a chartered physiotherapist. The classes will consist of 45 minutes of exercises aimed at improving balance, strength and walking and 45 minutes of education on topics such as fear of falling, task analysis, getting up from the floor, what devices can assist you – these will include group discussions and problem solving. There will also be a home exercise programme provided to each participant.
The MS research team at UL have conducted a feasibility study with a small group of 7 people with MS in Limerick to see if the programme could be implemented as it was designed. The research team are currently analysing the data collected from this study. Upon completion of the programme, the group participated in a focus group to identify what elements of the programme they thought worked well and what elements could be improved with suggestions for how this can be done. This feedback will enable the team to review the programme and make necessary changes before hopefully conducting a larger study in the future to investigate if ‘Better Balance’ can reduce falls for people with MS.
Who is involved?
This development was led by PhD student, Laura Comber, and involved reviewing information from previous research studies, asking physiotherapists and occupational therapists about what they felt was important to include in the intervention through interviews and gaining insight from people with MS through a survey of interest levels in intervention content and logistics of running the intervention. The MS research team at UL then collaborated with experienced researchers of falls in MS from the USA and Canada to design ‘Better Balance’.