Can We Be Taught How to Avoid an MS Fall?

Can We Be Taught How to Avoid an MS Fall?
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I’d just gotten out of bed the other morning and was headed to the bathroom using just one cane when I tried to step over a dog toy on the floor. I went down slowly onto the carpet, so it was really no big deal. No harm, no foul, but I should have been using two canes, and I should have been more careful.

I’ve written about the right way to fall. I try to push my canes away and and land on my side. The side landing was learned when I was a kid taking judo lessons.

In a New York Times article a few years ago, judo instructor Paul Schreiner had this advice: “Accept that you’re falling and go with it. Round your body … and distribute the energy so you take the fall in the widest area possible.”

But rather than teaching high-risk people how to fall, is it possible to teach them how to prevent falls like mine? Could nurses be trained as “falls care managers” to help reduce the risks?

Researching fall education

A recent study with an appropriate acronym —  STRIDE, or Strategies to Reduce Injuries and Develop Confidence in Elders — looked at whether individually tailored fall prevention programs implemented by nurses trained to be falls care managers could reduce the risk of serious falls in those 70 and older and considered to be high-risk.

The risks were defined as having problems with walking and balance, fall hazards in the home, vision problems, and using certain medications. Though the study wasn’t specifically aimed at people with multiple sclerosis, many of us with MS can relate to these risks. (I also can relate to being old.)

The falls care managers helped study participants identify their risk factors and choose up to three of them to be modified. The managers then helped the participants modify them. A control group received only an information pamphlet about preventing falls and were encouraged to discuss fall prevention with their primary care doctors.

Any training seems to help

The researchers believed that the rate of serious falls would be about 20% lower in the coached group than in the control group. But they were wrong. As reported in the The New England Journal of Medicine, both groups did better than expected.

It took longer than the researchers expected for the first serious fall injury to occur in both groups. The rate of hospitalization or death from a fall also was similar in both groups. The bottom line: It didn’t help to have a dedicated nurse as a coach, but it appears that any kind of fall prevention education is better than none.

What has your experience been like with falls? What are some tricks or techniques you use to reduce your risk of falling? Please share in the comments below. Also, you’re invited to visit my personal blog at www.themswire.com.

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 Note: Multiple Sclerosis News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Multiple Sclerosis News Today or its parent company, BioNews Services, and are intended to spark discussion about issues pertaining to multiple sclerosis.

Ed Tobias is a retired broadcast journalist. Most of his 40+ year career was spent as a manager with the Associated Press in Washington, DC. Tobias was diagnosed with Multiple Sclerosis in 1980 but he continued to work, full-time, meeting interesting people and traveling to interesting places, until retiring at the end of 2012.
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Ed Tobias is a retired broadcast journalist. Most of his 40+ year career was spent as a manager with the Associated Press in Washington, DC. Tobias was diagnosed with Multiple Sclerosis in 1980 but he continued to work, full-time, meeting interesting people and traveling to interesting places, until retiring at the end of 2012.

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18 comments

  1. Cynthia MacFarlane says:

    I have been having a physiotherapist come to My home to teach me exercises that could help me get up by myself , if I do fall ….but also to strengthen my legs to prevent falls .
    I use a rollator walker in the house.
    Thanks for your article.
    Helpful , as usual.

  2. Beverly K Walker says:

    I just fell Wednesday morning on both my knees and do they hurt now! I was coming into the house from my patio and my two Goldens went in first and then decided they wanted to go back out. Luckily I was holding onto the door handle and braced myself a little, but still! I don’t want to get rid of the dogs (yet!), but this is my third fall in the past 18 months, all of them my fault.

    • Ed Tobias says:

      Beverly,

      As a dog owner I know well that if that dog wants to go somewhere, or not go somewhere, the dog is the boss. And Goldens, though beautiful, are also pretty big! I always try to anticipate what my Cocker Spaniel will want to do and guard for it. It was worse when we had a cat, who was always under my feet. But, you’ve gotta love ’em.

      I’m glad you weren’t seriously hurt.

      Ed

  3. Bonnie Trown says:

    I do a lot of things to keep from falling but the thing all those efforts have in common is just slowing down a bit. I’m not talking about a crawl but I did move much faster in the past. Working on my core strength at the gym has also helped. I’ve had several broken bones from falls in the past so not falling is very important to me.

    • Ed Tobias says:

      Hi Bonnie,

      Ouch! Fortunately, I’ve never broken anything (I hope I didn’t just jinx that) but I have had a gash to my head. Core strength helps. I’ve also found that hippotherapy (horseback riding with a therapist) helped my balance a great deal, and it was fun.

      Ed

  4. Anthony H says:

    Hi Ed – Like you, I learnt fall techniques when I was young in pre-MS days doing gym leaps and tumbles. My three rules are (1) Don’t extend your hand to break your fall. It won’t break the fall, but it may well break your hand (or arm), (2) Crumple up at the knees and waist, (3) Twist around to take the fall evenly down the side of the body. For me, it is fortunately automatic – there is only a split second for it to click in when going down.

    So falls prevention it is. Keep paths clear and check for hazards on the floor. Always use the appropriate level of walking aids. Keep areas well-lit. Handrails in wet or uneven areas. I’m sure there are more rules or guidelines.

    • Ed Tobias says:

      Hi Anthony,

      I think your rules and suggestions are great. Wet areas are the most dangerous for me. Even with two tripod canes I’ve gone down. You really have to be on automatic…and on guard.

      Thanks for sharing,

      Ed

  5. Charles Lumia says:

    I think this is a great idea to look into.

    I’m fairly young (35) and I’ve fallen once due to the MS. As soon as I did I tried thinking of ways to make falling safer as it seems that it’s inevitable for me with my balance issues.

    Immediately I thought that some sort of tumbling exercises and practice would be a good idea. Gymnastics perhaps.

    • Ed Tobias says:

      I’m glad you’re thinking about this, Charles. At your age I think I’d try to solve the problem as its source…by trying to work on your balance. Have you talked with a physical therapist about this? Also, I don’t know if it’s your sort of thing but hippotherapy (horseback riding with a trained therapist) is both fun and great for balance and core strength.

      Ed

  6. FB says:

    Most of my falls happen when one of my legs will just give way under me and I crash to the floor like a ton of bricks. Not sure how this risk can be mitigated or reduced as it happens totally without warning, and the physios also don’t know what can be done either. Yes, one solution would be to always use my walker inside my house (I always use it away from home), but my ability to walk at all was extremely hard won after a week in an induced coma and three months in hospital and rehab for a health problem totally unrelated to MS. It’s a vexed question because using my walker all the time in my house would be a real nuisance i.e. no hands to do “stuff” because they’re on the walker handles, but I would probably dodge the occasional fall. However, the more I use my walker the less I maintain what sense of balance I have left, and as that deteriorates my falls risk increases. Definitely stuck between a rock and a hard place with both sides losing………

    • Ed Tobias says:

      FB,

      That’s certainly a toughie. All I can say is that I use a pair of canes everywhere when I’m not on my scooter. It’s tough carrying something, for sure, but I’d have a very tough time without them. With your walker, don’t you have some sort of pouch in which you can put as least some of the things that need to be carried?

      Ed

  7. RG says:

    I, too, have been victim to my beloved dogs. For the current bad 68 lb.girl, I’ve had to modify where and when I walk with her (and the 5 lb.Maltese). If I walk where we’d encounter people or other dogs, she’s like Baby Huey –> SO excited that she flies into the air, lunging with all her might to go visit –> and I follow behind her like a kite tail!
    And land with an audible “THUD!”

    MS has affected my balance, vision, depth perception, and reaction time. I now cruise walls – especially at night. Anthony H has some great rules & suggestions. Thanks so much!

    I agree that offering training on how to fall with the least risk of injury would be fabulous. This would benefit us in the emotional hurt also, lessen any feelings of embarrassment. It’s important to take several breaths and assess yourself before attempting to get up. You will be hurt but check if you’re injured (need medical assistance) and know how to give yourself home care after a fall –> rest, ice, Tylenol, hydrate.

    • Ed Tobias says:

      RG,

      Those dogs sound like two leash-fulls. My cocker loves to make friends…except for a couple of dogs that he doesn’t like, and you never know which they’ll be. Grrrr.

      Using a scooter to walk Joey helps keep me from being pulled over.

      Ed

  8. Deb H. says:

    After foot surgery made me even more unsteady and I’d had monthly falls, I started seeing a personal trainer, who was also a physical therapist with an MS mom. He helped me develop my leg strength, coordination & balance. We practiced simulated falls & recovery techniques assuming various injuries. As I lived alone at the time, the boost in confidence was huge. Best $ I ever spent!

  9. Cyndi says:

    I can’t say I’ve got falling down (pun intended)- but do you have any tips for or can you perhaps write about the revese problem! How to get back UP – particularly if alone in the house. Thanks. Always enjoy your articles.

    • Ed Tobias says:

      Hi Cyndi,

      That’s a very good point. The woman who writes one of the blogs that I follow is increasingly having that getting up problem. I’m fortunate that I have enough upper body strength to be able to pull myself up using my canes or furniture. If I can come up with any advice on rising up I’ll pass them along.

      Glad you enjoy the stuff I write. It makes my day.

      Ed

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