Date Presented 04/22/2023

A preintervention–postintervention study to evaluate iROLL-O, an online fall prevention intervention for people with multiple sclerosis who use a wheelchair or scooter, is described. Findings advance evidence-based fall prevention practice.

Primary Author and Speaker: Toni Van Denend

Additional Authors and Speakers: Amy McArthur

Contributing Authors: Elizabeth Walker Peterson, Deborah Backus, Jacob Sosnoff, Libak Abou, Arman Sandhu, Laura Rice

PURPOSE: To evaluate the efficacy of iROLL-O, a group-based, online, fall prevention intervention designed for people with multiple sclerosis (PwMS) who use a wheelchair or scooter (WC/S) that features self-management content. The paucity of evidence-based, accessible interventions for this unique population that can be delivered by occupational or physical therapists created the imperative for this study.

DESIGN: A pre/post intervention, longitudinal experimental study was utilized. Participants were recruited primarily from North American Research Committee on MS Registry. All had MS, >18 years old, and had a Patient Determined Disease Steps Score of 7.

METHOD: Fall prevalence data, gathered via a fall tracking log, was recorded 12 weeks prior to and 32 weeks post-intervention (44 weeks total). Assessment of other key dependent variables occurred 12-weeks prior to the start of IROLL-O, immediately post- and 32 weeks post-intervention. These variables included fear of falling (SCI-Falls Concern Scale); knowledge related to fall prevention/management (Fall Prevention/Management Questionnaire); and fall management (Fall Management Scale). Repeated measures one-way ANOVA evaluated the intervention effect over time. An LSD Post-Hoc test determined differences between timepoints. Cohen’s d effect sizes were estimated.

RESULTS: 12 participants completed the intervention. No significant change in fall incidence occurred. Fear of falling was significantly reduced following iROLL-O as measured by SCI-FCS scores (p<0.01, η2=0.47, d=0.80). Significant improvement in both FMS (p=0.04, η2=0.26, d=0.85) and FPMQ (p=0.03, η2=0.36, d=0.67) scores was observed.

CONCLUSION: iROLL-O has promise in achieving desired outcomes.

IMPACT STATEMENT: This study is first to evaluate the impact of an online fall prevention intervention for PwMS who use WC/S and will inform development of fall prevention programs for this vulnerable population.


Rice, L. A., Yarnot, R., Sung, J., Sosnoff, J. J., Backus, D., Abou, L., Shen, S., & Peterson, E. W. (2022). Pilot Study of a Fall Prevention and Management Intervention Program for People With Multiple Sclerosis Who Use a Wheelchair or Scooter Full-Time. Archives of Rehabilitation Research and Clinical Translation, 100225.

Rice, L. A., Peterson, E. W., Backus, D., Sung, J., Yarnot, R., Abou, L., Van Denend, T., Shen, S., & Sosnoff, J. J. (2019). Validation of an individualized reduction of falls intervention program among wheelchair and scooter users with multiple sclerosis. Medicine (Baltimore), 98(19), e15418.

Rice, L., Kalron, A., Berkowitz, S. H., Backus, D., & Sosnoff, J. J. (2017). Fall prevalence in people with multiple sclerosis who use wheelchairs and scooters. Medicine (Baltimore), 96(35), e7860.

McArthur, A., Peterson, E., Sosnoff, J., et al. (In review). Online delivery of the individualized reduction of falls intervention for people with multiple sclerosis who use a wheelchair or scooter full-time: A pilot study. International Journal of MS Care.