Educational and Exercise Intervention to Prevent Falls and Improve Participation in Subjects With Neurological Conditions: The NEUROFALL Randomized Controlled Trial

NEUROFALL Group

Research output: Contribution to journalArticle

Abstract

Background: Falls, mobility impairments and lack of social support lead to participation restrictions in people with neurological conditions. The aim of this multicenter, single blinded randomized controlled trial was to test whether an educational program focusing on fall prevention and safe mobility reduces falls and increases social participation among people with neurological conditions. Methods: Ninety people with Stroke (n = 25), multiple sclerosis (n = 33) and Parkinson disease (n = 32), median age 63 (31–89), were randomized. A permuted block algorithm stratified by field center was used to allocate participants to an education group (EG, n = 42) consisting of an educational program focused on fall prevention and tailored balance exercises and a control group (CG, n = 48) receiving usual treatments. After baseline assessment, each participants was followed for 6 months with telephone contacts by blinded interviewers. Being fallers (>1 fall) and time to become a faller were used as primary outcomes. Community Integration Questionnaire (CIQ) and Instrumental Activities of Daily Living (IADL) scales assessed treatment effects on social integration and daily living activities. Results: Over a median (Interquartile Range) follow-up of 189 (182–205) days, [EG = 188 (182–202), CG = 189 (182–209)] fallers were 10 in the CG and 11 in the EG (hazard ratio 0.95, 95% confidence interval (CI) 0.45 to 2.5; P = 0.94). At follow-up the EG scored significantly better than CG on the CIQ (+1.7 points, CI: 0.1 to 3.3) and IADL (+2.2 points, CI: 0.4 to 4.0). Conclusions: This educational program did not reduce the risk of falls but it improved the ability to carry out activities of daily living and decreased participation restrictions in people with neurological conditions.

Original languageEnglish
Article number865
JournalFrontiers in Neurology
Volume10
DOIs
Publication statusPublished - Sep 13 2019

Fingerprint

Activities of Daily Living
Randomized Controlled Trials
Community Integration
Confidence Intervals
Social Participation
Telephone
Social Support
Multiple Sclerosis
Parkinson Disease
Stroke
Interviews
Education
Control Groups
Therapeutics
Surveys and Questionnaires

Keywords

  • falls
  • neurological disease
  • participation
  • prevention
  • rehabilitation

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

@article{3d4c266068304327bdf47743eac2597a,
title = "Educational and Exercise Intervention to Prevent Falls and Improve Participation in Subjects With Neurological Conditions: The NEUROFALL Randomized Controlled Trial",
abstract = "Background: Falls, mobility impairments and lack of social support lead to participation restrictions in people with neurological conditions. The aim of this multicenter, single blinded randomized controlled trial was to test whether an educational program focusing on fall prevention and safe mobility reduces falls and increases social participation among people with neurological conditions. Methods: Ninety people with Stroke (n = 25), multiple sclerosis (n = 33) and Parkinson disease (n = 32), median age 63 (31–89), were randomized. A permuted block algorithm stratified by field center was used to allocate participants to an education group (EG, n = 42) consisting of an educational program focused on fall prevention and tailored balance exercises and a control group (CG, n = 48) receiving usual treatments. After baseline assessment, each participants was followed for 6 months with telephone contacts by blinded interviewers. Being fallers (>1 fall) and time to become a faller were used as primary outcomes. Community Integration Questionnaire (CIQ) and Instrumental Activities of Daily Living (IADL) scales assessed treatment effects on social integration and daily living activities. Results: Over a median (Interquartile Range) follow-up of 189 (182–205) days, [EG = 188 (182–202), CG = 189 (182–209)] fallers were 10 in the CG and 11 in the EG (hazard ratio 0.95, 95{\%} confidence interval (CI) 0.45 to 2.5; P = 0.94). At follow-up the EG scored significantly better than CG on the CIQ (+1.7 points, CI: 0.1 to 3.3) and IADL (+2.2 points, CI: 0.4 to 4.0). Conclusions: This educational program did not reduce the risk of falls but it improved the ability to carry out activities of daily living and decreased participation restrictions in people with neurological conditions.",
keywords = "falls, neurological disease, participation, prevention, rehabilitation",
author = "{NEUROFALL Group} and Davide Cattaneo and Elisa Gervasoni and Elisabetta Pupillo and Elisa Bianchi and Irene Aprile and Isabella Imbimbo and Rita Russo and Arianna Cruciani and Andrea Turolla and Johanna Jonsdottir and Michela Agostini and Ettore Beghi",
year = "2019",
month = "9",
day = "13",
doi = "10.3389/fneur.2019.00865",
language = "English",
volume = "10",
journal = "Frontiers in Neurology",
issn = "1664-2295",
publisher = "Frontiers Research Foundation",

}

TY - JOUR

T1 - Educational and Exercise Intervention to Prevent Falls and Improve Participation in Subjects With Neurological Conditions

T2 - The NEUROFALL Randomized Controlled Trial

AU - NEUROFALL Group

AU - Cattaneo, Davide

AU - Gervasoni, Elisa

AU - Pupillo, Elisabetta

AU - Bianchi, Elisa

AU - Aprile, Irene

AU - Imbimbo, Isabella

AU - Russo, Rita

AU - Cruciani, Arianna

AU - Turolla, Andrea

AU - Jonsdottir, Johanna

AU - Agostini, Michela

AU - Beghi, Ettore

PY - 2019/9/13

Y1 - 2019/9/13

N2 - Background: Falls, mobility impairments and lack of social support lead to participation restrictions in people with neurological conditions. The aim of this multicenter, single blinded randomized controlled trial was to test whether an educational program focusing on fall prevention and safe mobility reduces falls and increases social participation among people with neurological conditions. Methods: Ninety people with Stroke (n = 25), multiple sclerosis (n = 33) and Parkinson disease (n = 32), median age 63 (31–89), were randomized. A permuted block algorithm stratified by field center was used to allocate participants to an education group (EG, n = 42) consisting of an educational program focused on fall prevention and tailored balance exercises and a control group (CG, n = 48) receiving usual treatments. After baseline assessment, each participants was followed for 6 months with telephone contacts by blinded interviewers. Being fallers (>1 fall) and time to become a faller were used as primary outcomes. Community Integration Questionnaire (CIQ) and Instrumental Activities of Daily Living (IADL) scales assessed treatment effects on social integration and daily living activities. Results: Over a median (Interquartile Range) follow-up of 189 (182–205) days, [EG = 188 (182–202), CG = 189 (182–209)] fallers were 10 in the CG and 11 in the EG (hazard ratio 0.95, 95% confidence interval (CI) 0.45 to 2.5; P = 0.94). At follow-up the EG scored significantly better than CG on the CIQ (+1.7 points, CI: 0.1 to 3.3) and IADL (+2.2 points, CI: 0.4 to 4.0). Conclusions: This educational program did not reduce the risk of falls but it improved the ability to carry out activities of daily living and decreased participation restrictions in people with neurological conditions.

AB - Background: Falls, mobility impairments and lack of social support lead to participation restrictions in people with neurological conditions. The aim of this multicenter, single blinded randomized controlled trial was to test whether an educational program focusing on fall prevention and safe mobility reduces falls and increases social participation among people with neurological conditions. Methods: Ninety people with Stroke (n = 25), multiple sclerosis (n = 33) and Parkinson disease (n = 32), median age 63 (31–89), were randomized. A permuted block algorithm stratified by field center was used to allocate participants to an education group (EG, n = 42) consisting of an educational program focused on fall prevention and tailored balance exercises and a control group (CG, n = 48) receiving usual treatments. After baseline assessment, each participants was followed for 6 months with telephone contacts by blinded interviewers. Being fallers (>1 fall) and time to become a faller were used as primary outcomes. Community Integration Questionnaire (CIQ) and Instrumental Activities of Daily Living (IADL) scales assessed treatment effects on social integration and daily living activities. Results: Over a median (Interquartile Range) follow-up of 189 (182–205) days, [EG = 188 (182–202), CG = 189 (182–209)] fallers were 10 in the CG and 11 in the EG (hazard ratio 0.95, 95% confidence interval (CI) 0.45 to 2.5; P = 0.94). At follow-up the EG scored significantly better than CG on the CIQ (+1.7 points, CI: 0.1 to 3.3) and IADL (+2.2 points, CI: 0.4 to 4.0). Conclusions: This educational program did not reduce the risk of falls but it improved the ability to carry out activities of daily living and decreased participation restrictions in people with neurological conditions.

KW - falls

KW - neurological disease

KW - participation

KW - prevention

KW - rehabilitation

UR - http://www.scopus.com/inward/record.url?scp=85072884821&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85072884821&partnerID=8YFLogxK

U2 - 10.3389/fneur.2019.00865

DO - 10.3389/fneur.2019.00865

M3 - Article

AN - SCOPUS:85072884821

VL - 10

JO - Frontiers in Neurology

JF - Frontiers in Neurology

SN - 1664-2295

M1 - 865

ER -