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Clinical Trial ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00865

Educational and exercise intervention to prevent falls and improve participation in subjects with neurological conditions: the NEUROFALL randomized controlled trial

 Davide Cattaneo1*, Elisa Gervasoni1, Elisabetta Pupillo2,  Elisa Bianchi2,  Irene Aprile1,  Isabella Imbimbo1, Rita Russo3, Arianna Cruciani1,  Andrea Turolla4,  Johanna Jonsdottir1,  Michela Agostini4 and  Ettore Beghi2
  • 1Fondazione Don Carlo Gnocchi Onlus (IRCCS), Italy
  • 2Istituto Di Ricerche Farmacologiche Mario Negri, Italy
  • 3San Carlo Borromeo Hospital, Italy
  • 4IRCCS Fondazione Ospedale San Camillo, Italy

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 six 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) 0.45to2.5;P=0.94). At follow-up the EG scored significantly better than CG on the CIQ (+1.7 points,CI:0.1to3.3) and IADL (+2.2 points,CI:0.4to4.0).
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: prevention, falls, Participation, Neurological Disease, Rehabilitation

Received: 01 Feb 2019; Accepted: 26 Jul 2019.

Edited by:

Lisa T. Connor, Washington University in St. Louis, United States

Reviewed by:

Marco Iosa, Fondazione Santa Lucia (IRCCS), Italy
Maw Pin Tan, University of Malaya, Malaysia  

Copyright: © 2019 Cattaneo, Gervasoni, Pupillo, Bianchi, Aprile, Imbimbo, Russo, Cruciani, Turolla, Jonsdottir, Agostini and Beghi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Davide Cattaneo, Fondazione Don Carlo Gnocchi Onlus (IRCCS), Milan, Italy, dcattaneo@dongnocchi.it