title: Balance exercise program reduced falls in people with multiple sclerosis: a single-group, pretest-posttest trial.
abstract: OBJECTIVE
  To evaluate the effects of a balance exercise program on falls in people with mild to moderate multiple sclerosis (MS).
  
  
  METHODS
  Multicenter, single-blinded, single-group, pretest-posttest trial.
  
  
  METHODS
  Seven rehabilitation units within 5 county councils.
  
  
  METHODS
  Community-dwelling adults with MS (N=32) able to walk 100m but unable to maintain 30-second tandem stance with arms alongside the body.
  
  
  METHODS
  Seven weeks of twice-weekly, physiotherapist-led 60-minute sessions of group-based balance exercise targeting core stability, dual tasking, and sensory strategies (CoDuSe).
  
  
  METHODS
  Primary outcomes: number of prospectively reported falls and proportion of participants classified as fallers during 7 preintervention weeks, intervention period, and 7 postintervention weeks. Secondary outcomes: balance performance on the Berg Balance Scale, Four Square Step Test, sit-to-stand test, timed Up and Go test (alone and with cognitive component), and Functional Gait Assessment Scale; perceived limitations in walking on the 12-item MS Walking Scale; and balance confidence on the Activities-specific Balance Confidence Scale rated 7 weeks before intervention, directly after intervention, and 7 weeks later.
  
  
  RESULTS
  Number of falls (166 to 43; P≤.001) and proportion of fallers (17/32 to 10/32; P≤.039) decreased significantly between the preintervention and postintervention periods. Balance performance improved significantly. No significant differences were detected for perceived limitations in walking, balance confidence, the timed Up and Go test, or sit-to-stand test.
  
  
  CONCLUSIONS
  The CoDuSe program reduced falls and proportion of fallers and improved balance performance in people with mild to moderate MS but did not significantly alter perceived limitations in walking and balance confidence.
authors.affiliation: Centre for Health Care Sciences, Örebro County Council, Örebro, Sweden; School of Medicine and Health, Örebro University, Örebro, Sweden. Electronic address: ylva.nilsagard@orebroll.se.
authors.forename: Ylva Elisabet
authors.initials: YE
authors.lastname: Nilsagård
authors.affiliation: Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Solna, Sweden; Department of Neurology, Karolinska University Hospital, Solna, Sweden.
authors.forename: Lena Kristina
authors.initials: LK
authors.lastname: von Koch
authors.affiliation: Rehabunit, Central Hospital Karlstad, Karlstad, Sweden.
authors.forename: Malin
authors.initials: M
authors.lastname: Nilsson
authors.affiliation: School of Medicine and Health, Örebro University, Örebro, Sweden; Family Medicine Research Centre, Örebro County Council, Örebro, Sweden.
authors.forename: Anette Susanne
authors.initials: AS
authors.lastname: Forsberg
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D005080:Exercise Test; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000503:physiopathology* / Q000534:rehabilitation*; D004856:Postural Balance / Q000502:physiology*; D016037:Single-Blind Method
keywords: Accidental falls; Exercise; Multiple sclerosis; Postural balance; Rehabilitation; Walking