Self-management of falls in people with multiple sclerosis: A scoping review.
Susanna Tuvemo Johnson, Maria Flink, Elizabeth Peterson and 5 others
PMID 36177511WHAT IT FOUND
Self-management programs for falls in multiple sclerosis are common but poorly defined.
Randomized trials showed no reduction in falls, though some improved daily activities. Most programs target ambulatory patients, leaving non-ambulatory needs unaddressed.
Key findings
01None of the 14 included publications provided a definition of self-management, despite describing interventions as self-management programs.
02Three randomized controlled trials found no significant difference between intervention and control groups regarding fall rates.
03All six intervention programs reviewed targeted primarily ambulatory people with multiple sclerosis, excluding the needs of non-ambulatory patients.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The review is limited to English-language publications, which may introduce selection bias. Only 14 publications were included, and the field is described as being in its infancy. The initial screening relied on titles and abstracts, so relevant studies might have been missed. The use of manifest-directed content analysis means only explicitly stated components were coded, potentially underrepresenting self-management elements in interventions where they were implied but not named. The included studies varied widely in design (RCTs, pilots, qualitative), making it difficult to draw firm conclusions about efficacy.
Declared interests
The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
The easy way to misread this
Do not assume that 'self-management' interventions are proven to prevent falls in multiple sclerosis. The three randomized controlled trials found no significant difference in fall rates compared to controls. The label 'self-management' was applied inconsistently across studies, often without a clear definition or evidence of efficacy for the primary outcome of falling.