PT  - JOURNAL ARTICLE
AU  - Hildebrand, Andrea
AU  - Martini, Douglas
AU  - Fling, Brett
AU  - Cameron, Michelle
TI  - Ambulation Assistive Device Training Prevents Falls, Increases Device Satisfaction and May Decrease Sitting and Increase Walking in MS: A Randomized-Controlled Pilot Study (S24.004)
DP  - 2017 Apr 18
TA  - Neurology
PG  - S24.004
VI  - 88
IP  - 16 Supplement
4099  - http://n.neurology.org/content/88/16_Supplement/S24.004.short
4100  - http://n.neurology.org/content/88/16_Supplement/S24.004.full
SO  - Neurology2017 Apr 18; 88
AB  - Objective: To estimate the impact of ambulation assistive device training on falls, device satisfaction, walking, and mobility in people with multiple sclerosis (MS).Background: Ambulation assistive devices such as canes and walkers are often used to improve mobility and prevent falls but are associated with increased falls. Training in use of these devices may optimize their benefits but no published studies have evaluated the impact of such training.Design/Methods: 40 people with MS reporting using an ambulation assistive device and also falling at least once in the past year were enrolled in this single-blind randomized waitlist controlled pilot trial. Subjects received 6 weekly 1-on-1 training sessions or were assigned to a waitlist. Mobility measures and patient-reported outcomes were assessed at baseline, at program completion, and 3 months later. Falls were counted prospectively throughout using daily fall calendars.Results: At baseline groups were well matched on all outcomes. In the 3 months following intervention there were significantly fewer fallers in the training group than in the control group (χ2 =3.96, p=0.047) and, at program completion, significantly greater improvement in device satisfaction (Quebec User Evaluation of Satisfaction with assistive Technology, t= −2.15, p=0.04). There were trends for a greater decrease in average daily sitting time after the program (Cohen’s d=0.53, p=0.11) and a greater increase in walking time at 3 months (Cohen’s d=0.63, p=0.08). There were no appreciated between-group differences or within-group mean changes in walking speed measures.Conclusions: Although limited by small sample size, this study suggests that ambulation assistive device training prevents falls and increases device satisfaction and may decrease sitting time and increase walking time among PwMS who use an assistive device and have fallen in the past year. A full scale randomized controlled trial is needed to fully understand the impact of this intervention.Study Supported by: Department of Veterans Affairs, Rehabilitation Research & Development Service, Small Projects in Research grant # RX001918-01Disclosure: Dr. Hildebrand has nothing to disclose. Dr. Martini has nothing to disclose. Dr. Fling has nothing to disclose. Dr. Cameron has received personal compensation for activities with ReWalk and Adamas as a consultant.