Development of a balance, safe mobility and falls management programme for people with multiple sclerosis

Abstract

Purpose: To utilise stakeholder input to inform the structure, format and approach of a multiple sclerosis (MS) balance, safe mobility and falls management programme.

Materials and methods: Using a three-round nominal group technique, participants individually rated their agreement with 20 trigger statements, followed by a facilitated group discussion and re-rating. Three mixed groups included service users (n = 15) and providers (n = 19). Quantitative analysis determined agreement, whilst qualitative responses were analysed thematically.

Results: Median scores for each of the 20 trigger statements did not change significantly over sequential rounds, however, deviations around the medians indicated more agreement amongst participants over time.

Key recommendations were:

Aims and approach: The programme should be tailored to the needs of people with MS. Falls and participation-based outcomes are equally important.

Structure and format: The programme should balance expected burden and anticipated benefit, moving away from models requiring weekly attendance and promoting and supporting self-efficacy.

Optimising engagement: Support to maintain engagement and intensity of practice over the long term is essential.

Sustainability: Adequate funding is necessary. Staff should have MS specific knowledge and experience.

Conclusions: Participants collaboratively identified critical components of a MS balance, safe mobility and falls management programme. They also highlighted the importance of a collaborative, user-centred, MS-specific approach.

Implications for Rehabilitation

• People with multiple sclerosis need condition-specific interventions focussed on maximising balance and safe mobility and reducing falls.

• Programme design should support self-efficacy and flexible engagement.

• Adequate support and funding are seen as essential by both service users and providers.

Keywords:

• Self-management
• multiple sclerosis
• accidental falls
• balance
• rehabilitation
• nominal group technique

Acknowledgements

The authors would like to express their appreciation to the project funders and all the participants who contributed their time and energy to the nominal group sessions.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Multiple Sclerosis Society10.13039/501100000381990

This work was supported by the Multiple Sclerosis Society in the United Kingdom (innovative grant ref.: 990).