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Assistive Device Training in Multiple Sclerosis

Not Applicable
Completed
Conditions
Multiple Sclerosis
Interventions
Behavioral: Assistive Device Training
Registration Number
NCT02408718
Lead Sponsor
Portland VA Medical Center
Brief Summary

The purpose of this study is to determine whether a training program in the use of ambulatory assistive devices (such as canes, walkers, etc) can reduce falls and increase functional mobility and neural connectivity in people with Multiple Sclerosis.

Detailed Description

40 people with Multiple Sclerosis, who routinely use ambulatory assistive devices and have fallen at least once in the past year, will be randomized into two groups. One group will receive a 6-week training program in the use of their assistive device; the other group will be wait-listed, and may choose to receive the training after their participation in the study is completed. All participants will receive mobility assessments at baseline, 6-8 weeks later, and 3 months after that. All participants will record their falls on falls calendars. Participants in the training group will receive MRI scans to assess neural connectivity at baseline and after completion of the training program.

The purpose of the study is to determine whether participation in the training program reduces falls and increases functional mobility when compared to the wait-listed group, and also to determine whether any change in neural connectivity, as assessed by MRI scans, is seen in those who participate in the training.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Multiple Sclerosis of any type,
  • self-reported history of at least 1 fall in the previous year,
  • able to walk at least 25 feet with or without an assistive device,
  • clinically stable Multiple Sclerosis (no relapse in 30 days prior to enrollment),
  • intermittent or constant unilateral or bilateral assistance required to walk,
  • right-handed, willingness to remain consistent with medication use and level of physical activity for the duration of the study.
Exclusion Criteria
  • serious psychiatric or medical conditions that would preclude reliable participation in the study,
  • dementia (MMSE <24),
  • deafness,
  • blindness,
  • inability to follow directions in English,
  • significant upper extremity tremor or weakness,
  • more than 1 hour of assistive device training within the previous 3 years,
  • any exclusions to receiving MRI scans (implanted devices, anxiety, claustrophobia, body weight over 350 lbs).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Training groupAssistive Device TrainingSubjects randomized to this group will receive a 6 week Assistive Device Training program in the use of their assistive device. They will have mobility assessments taken at baseline, after the training program has been completed, and 3 months later. During this time, their falls will be recorded monthly using prospective falls calendars. Members of this group will also receive MRI scans at baseline and after the completion of the training program.
Primary Outcome Measures
NameTimeMethod
Change from Baseline in Functional Neural Connectivity (fMRI) at Completion of TrainingAt baseline, 1 week after completion of training

Resting-state (task free) functional Magnetic Resonance Imaging (fcMRI)

Change from Baseline in Functional Mobility at Completion of Training and the Following Three MonthsAt baseline, 1 week after completion of training, 3 months later

Timed Up and Go test, Timed 25-Foot Walk, 2 minute timed walk), Multiple Sclerosis Walking Scale-12

Change from Baseline in Falls at Completion of Training and the Following Three MonthsFirst week of training, last week of training, 3 months later

Change in rate of falls between time frames

Secondary Outcome Measures
NameTimeMethod
Change from Baseline in Satisfaction with Assistive Device at Completion of Training and the Following Three MonthsAt baseline, 1 week after completion of training, 3 months later

Quebec User Evaluation of Satisfaction with Assistive Technologies

Change from Baseline in Balance Confidence at Completion of Training and the Following Three MonthsAt baseline, 1 week after completion of training, 3 months later

Activities-specific Balance Confidence Questionnaire

Change from Baseline in Multiple Sclerosis Impact at Completion of Training and the Following Three MonthsAt baseline, 1 week after completion of training, 3 months later

Multiple Sclerosis Impact Scale-29

Change from Baseline in Physical Activity at Completion of Training and the Following Three MonthsAt baseline, 1 week after completion of training, 3 months later

International Physical Activity Questionnaire

Trial Locations

Locations (1)

VA Portland Health Care System

🇺🇸

Portland, Oregon, United States

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