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. 2017 Jul 27:4:26.
doi: 10.1186/s40814-017-0168-1. eCollection 2018.

Balance Right in Multiple Sclerosis (BRiMS): a guided self-management programme to reduce falls and improve quality of life, balance and mobility in people with secondary progressive multiple sclerosis: a protocol for a feasibility randomised controlled trial

H Gunn  1 , J Andrade  2 , L Paul  3 , L Miller  3   4 , S Creanor  5   6 , C Green  7 , J Marsden  1 , P Ewings  8 , M Berrow  5 , J Vickery  5 , A Barton  9 , B Marshall  10 , J Zajicek  11 , J A Freeman  1
Affiliations

Balance Right in Multiple Sclerosis (BRiMS): a guided self-management programme to reduce falls and improve quality of life, balance and mobility in people with secondary progressive multiple sclerosis: a protocol for a feasibility randomised controlled trial

H Gunn et al. Pilot Feasibility Stud. .

Erratum in

  • Erratum to: Pilot and Feasibility Studies, Vol. 4.
    Pilot and Feasibility Studies. Pilot and Feasibility Studies. Pilot Feasibility Stud. 2017 Oct 24;3:48. doi: 10.1186/s40814-017-0183-2. eCollection 2017. Pilot Feasibility Stud. 2017. PMID: 29123916 Free PMC article.

Abstract

Background: Impaired mobility is a cardinal feature of multiple sclerosis (MS) and is rated by people with MS as their highest priority. By the secondary progressive phase, balance, mobility and physical activity levels are significantly compromised; an estimated 70% of people with secondary progressive MS fall regularly. Our ongoing research has systematically developed 'Balance Right in MS' (BRiMS), an innovative, manualised 13-week guided self-management programme tailored to the needs of people with MS, designed to improve safe mobility and minimise falls. Our eventual aim is to assess the clinical and cost effectiveness of BRiMS in people with secondary progressive MS by undertaking an appropriately statistically powered, multi-centre, assessor-blinded definitive, randomised controlled trial. This feasibility study will assess the acceptability of the intervention and test the achievability of running such a definitive trial.

Methods/design: This is a pragmatic multi-centre feasibility randomised controlled trial with blinded outcome assessment. Sixty ambulant people with secondary progressive MS who self-report two or more falls in the previous 6 months will be randomly allocated (1:1) to either the BRiMS programme plus usual care or to usual care alone. All participants will be assessed at baseline and followed up at 15 weeks and 27 weeks post-randomisation. The outcomes of this feasibility trial include:Feasibility outcomes, including trial recruitment, retention and completionAssessment of the proposed outcome measures for the anticipated definitive trial (including measures of walking, quality of life, falls, balance and activity level)Measures of adherence to the BRiMS programmeData to inform the economic evaluation in a future trialProcess evaluation (assessment of treatment fidelity and qualitative evaluation of participant and treating therapist experience).

Discussion: The BRiMS intervention aims to address a key concern for MS service users and providers. However, there are several uncertainties which need to be addressed prior to progressing to a full-scale trial, including acceptability of the BRiMS intervention and practicality of the trial procedures. This feasibility trial will provide important insights to resolve these uncertainties and will enable a protocol to be finalised for use in the definitive trial.

Trial registration: ISRCTN13587999.

Keywords: Accidental falls; Balance; Exercise; Feasibility randomised controlled trial; Mobility; Quality of life; Secondary progressive multiple sclerosis; Self-management.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol, participant information and enrolment procedures were assessed and approved through the National Research Ethics Scheme (NRES Committee South West -Exeter REC ref no. 16/SW/0266) and the NHS Health Research Authority (HRA) (ref IRAS 199153). Any amendments to the protocol will be reported to, and approved via NRES, the HRA.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Participant pathway
Fig. 2
Fig. 2
BRiMS programme activities
See this image and copyright information in PMC

References

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