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CoDuSe group exercise programme improves balance and reduces falls in people with multiple sclerosis: A multi-centre, randomized, controlled pilot study
Örebro University, School of Medical Sciences. University Healthcare Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; Department of Physiotherapy, Faculty of Health and Medical Sciences, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-2598-2317
Örebro University, School of Health Sciences. University Healthcare Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.ORCID iD: 0000-0002-6768-5740
Örebro University, School of Medical Sciences. Department of Neurology.
Örebro University, School of Health Sciences. Örebro University Hospital. University Healthcare Research Centre.ORCID iD: 0000-0002-9760-3785
2017 (English)In: Multiple Sclerosis, ISSN 1352-4585, E-ISSN 1477-0970, Vol. 23, no 10, p. 1394-1404Article in journal (Refereed) Published
Abstract [en]

Background: Imbalance leading to falls is common in people with multiple sclerosis (PwMS).

Objective: To evaluate the effects of a balance group exercise programme (CoDuSe) on balance and walking in PwMS (Expanded Disability Status Scale, 4.0-7.5).

Methods: A multi-centre, randomized, controlled single-blinded pilot study with random allocation to early or late start of exercise, with the latter group serving as control group for the physical function measures. In total, 14 supervised 60-minute exercise sessions were delivered over 7 weeks. Pretest-posttest analyses were conducted for self-reported near falls and falls in the group starting late. Primary outcome was Berg Balance Scale (BBS). A total of 51 participants were initially enrolled; three were lost to follow-up.

Results: Post-intervention, the exercise group showed statistically significant improvement (p = 0.015) in BBS and borderline significant improvement in MS Walking Scale (p = 0.051), both with large effect sizes (3.66; -2.89). No other significant differences were found between groups. In the group starting late, numbers of falls and near falls were statistically significantly reduced after exercise compared to before (p < 0.001; p < 0.004).

Conclusion: This pilot study suggests that the CoDuSe exercise improved balance and reduced perceived walking limitations, compared to no exercise. The intervention reduced falls and near falls frequency.

Place, publisher, year, edition, pages
London, United Kingdom: Sage Publications, 2017. Vol. 23, no 10, p. 1394-1404
Keywords [en]
Accidental falls, exercise, multiple sclerosis, postural balance, core stability
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-53488DOI: 10.1177/1352458516677591ISI: 000407918800014PubMedID: 27834736Scopus ID: 2-s2.0-85027895184OAI: oai:DiVA.org:oru-53488DiVA, id: diva2:1046495
Note

Funding Agencies:

Uppsala-Örebro Regional Research Committe  

Research committee of Örebro County Council  

Norrbacka-Eugenia Foundation 

Available from: 2016-11-14 Created: 2016-11-14 Last updated: 2018-11-19Bibliographically approved
In thesis
1. Impaired balance and fall risk in people with multiple sclerosis
Open this publication in new window or tab >>Impaired balance and fall risk in people with multiple sclerosis
2018 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The symptoms from the neurological disease multiple sclerosis vary from person to person and over time. Impaired balance is common in people with multiple sclerosis and can lead to falls. Fall frequency is high in people with multiple sclerosis, above 50%. Multiple sclerosis affects not only the person having the disease but also their next of kin. To be able to reduce fall risk it is important to know when, why and where people with multiple sclerosis fall, and how to improve balance and reduce falls with exercise. It is also important to know how the falls affect the residing next of kin to people with multiple sclerosis.

The overall aim of this thesis was to gain enhanced knowledge by investigating when and why people with MS fall and how these falls possibly affect their next of kin, and also to evaluate the effects and perceptions of participating in a specific balance exercise.

Data were gathered using four different data collections, and this thesis contains both qualitative and quantitative data.

The major finding in this thesis is that people with multiple sclerosis fall in the course of everyday life activities, most often in their own homes due to various intrinsic and extrinsic factors. Balance can be improved and falls reduced and everyday life may be made easier and facilitated after participating in the CoDuSe balance exercise. This is important also for the next of kin, since they are adapting, adjusting and renouncing their activities due to the falls of the PwMS, in order to make it work for the whole family.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2018. p. 94
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 184
Keywords
Balance, exercise, falls, falls efficacy, gait, multiple sclerosis, next of kin, physiotherapy, qualitative research, randomized controlled trial
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-68025 (URN)978-91-7529-263-2 (ISBN)
Public defence
2018-11-16, Örebro universitet, Campus USÖ, hörsal C3, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2018-07-23 Created: 2018-07-23 Last updated: 2018-12-10Bibliographically approved

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Carling, AnnaForsberg, AnetteGunnarsson, MartinNilsagård, Ylva

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