Michelle H Cameron, Andrea Hildebrand, Cinda L Hugos, Grace I Judd, Garnett McMillan, Peter G Jacobs
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引用次数: 5
Abstract
Background: People with multiple sclerosis (PwMS) fall frequently. Community-delivered exercise and education reduce falls in older adults, but their efficacy in multiple sclerosis (MS) is unknown.
Objectives: To evaluate the impact of the Free From Falls (FFF) group education and exercise program on falls in PwMS.
Methods: This was a prospective, assessor-blinded, two-arm parallel randomized controlled trial. Ninety-six participants were randomized to FFF (eight weekly 2 hour sessions) or the control condition (a fall prevention brochure and informing their neurologist of their fall history). Participants counted falls prospectively from enrollment through 6 months following intervention. Effects on fall frequency were evaluated by the Bayesian analysis.
Results: The modeled mean fall frequency pre-intervention was 1.2 falls/month in the FFF group (95% credible intervals (CIs) = 0.8-2.0) and 1.4 falls/month in the control group (95% CI = 0.9-2.1). Fall frequency decreased by 0.6 falls/month in both groups over time (nadir 4-6 months post-intervention: FFF 0.6 falls/month (95% CI = 0.4-0.9); control 0.8 falls/month (95% CI = 0.5-1.1)).
Conclusion: In-person group exercise and education are not superior to written education and neurologist-initiated interventions for preventing falls in PwMS.
背景:多发性硬化症(PwMS)患者经常跌倒。社区提供的运动和教育减少老年人跌倒,但其对多发性硬化症(MS)的疗效尚不清楚。目的:评价自由摔伤(FFF)团体教育和锻炼项目对PwMS患者摔伤的影响。方法:这是一项前瞻性、评估盲、两组平行随机对照试验。96名参与者被随机分为FFF组(每周8次,每次2小时)或对照组(一本预防跌倒的小册子,并告知他们的神经科医生他们的跌倒史)。参与者从入组到干预后6个月对跌倒进行了前瞻性统计。通过贝叶斯分析评估对坠落频率的影响。结果:干预前模型平均跌倒频率FFF组为1.2次/月(95%可信区间(CI) = 0.8-2.0),对照组为1.4次/月(95% CI = 0.9-2.1)。随着时间的推移,两组跌倒频率均下降0.6次/月(干预后4-6个月的最低点:FFF 0.6次/月(95% CI = 0.4-0.9);对照组0.8次/月(95% CI = 0.5-1.1))。结论:在预防PwMS患者跌倒方面,面对面的团体运动和教育并不优于书面教育和神经科医生发起的干预措施。