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Study protocol of a randomized controlled trial comparing backward walking to forward walking training on balance in multiple sclerosis: The TRAIN-MS trial.

Contemporary clinical trials
September 1, 2024
Michael VanNostrand et al. (4 authors)
Clinical Trial ProtocolJournal ArticleHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine the feasibility, acceptability, and impact of 8-week backward walking training (TRAIN-BW) compared to forward walking training (TRAIN-FW) on static, anticipatory, and reactive balance, as well as secondary outcomes like walking velocity, balance confidence, and fall rates in persons with multiple sclerosis (PwMS).

Results Summary

The study proposes to evaluate the effects of backward walking training on balance and fall-related outcomes in PwMS, but results are not yet reported as it is a randomized controlled trial in progress. Limitations include the lack of reported findings and reliance on future data collection.

Population

Ninety individuals with multiple sclerosis (PwMS) who have self-reported walking dysfunction or ≥2 falls in the past 6 months, stratified by sex and disease severity.

Effective Dosage

Not specified (intervention involves 8 weeks of backward walking training).

Duration

8 weeks of training, with follow-up measurements for 6 months post-intervention.

Interactions

None mentioned

Extracted Claims (6)
InterventionDirectionEndpointPopulationDosageImpactClaim #
exercise
increase
mobility and functioning
persons with multiple sclerosis (PwMS)
-
proven to be an effective intervention for improving
#1
current exercise approaches
no change
forward walking (FW) and balance training
persons with multiple sclerosis (PwMS)
-
predominantly emphasize
#2
current exercise approaches
increase
balance and fall rates
persons with multiple sclerosis (PwMS)
-
with variable improvements in
#3
Backward walking (BW)
increase
mobility and strength outcomes
-
-
has emerged as a promising intervention modality for enhancing
#4
backward walking training (TRAIN-BW)
neutral
static, anticipatory, and reactive balance
individuals with MS with self-reported walking dysfunction or ≥ 2 falls in the past 6 months
-
aims to determine the feasibility, acceptability, and impact of
#5
backward walking training (TRAIN-BW)
decrease
balance impairments and falls
persons with MS
-
may be an innovative intervention to address
#6
Abstract

Balance impairment and accidental falls are a pervasive challenge faced by persons with multiple sclerosis (PwMS), significantly impacting their quality of life. While exercise has proven to be an effective intervention for improving mobility and functioning in PwMS, current exercise approaches predominantly emphasize forward walking (FW) and balance training, with variable improvements in balance and fall rates. Backward walking (BW) has emerged as a promising intervention modality for enhancing mobility and strength outcomes; however, significant gaps remain. Specifically, there is limited knowledge about the efficacy of BW interventions on outcomes such as static, anticipatory, and reactive balance, balance confidence, falls, and cognition. This randomized controlled trial aims to determine the feasibility, acceptability, and impact of 8-weeks of backward walking training (TRAIN-BW) as compared to forward walking training (TRAIN-FW). Ninety individuals with MS with self-reported walking dysfunction or ≥ 2 falls in the past 6 months will be randomized in blocks, stratified by sex and disease severity to either the TRAIN-BW or TRAIN-FW intervention groups. Adherence and retention rates will be used to determine feasibility and the Client Satisfaction Questionnaire will be used to assess acceptability. The primary outcomes will be static, anticipatory, and reactive balance. Secondary outcomes include walking velocity, balance confidence, concern about falling, cognition, physical activity, and fall rates measured prospectively for 6 months after post-testing. Additionally, the extent to which cognitive functioning influences response to intervention will be examined. Backward walking training may be an innovative intervention to address balance impairments and falls in persons with MS.

Medical Subject Headings (MeSH)
AdultFemaleHumansMaleMiddle AgedAccidental FallsExercise TherapyFeasibility StudiesMultiple SclerosisPostural BalanceQuality of LifeWalkingRandomized Controlled Trials as Topic
Study Links
Quality Scores
SafetyNot Assessed
Efficacy60/10
Quality80/10
Citation Metrics
Total Citations1
Citations/Year1.0
Research Impact Scores
APT Score0.25
Weight Score2.60
Normalized Score0.60
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