CClinicalTrials.gg
Not yet recruitingNCT07378566STARUpdated Jan 30, 2026

Intervention to Master Complex Fall Risk Situations in Persons With Multiple Sclerosis (STAR)

An interventional study of Individual strategies in Multiple Sclerosis and Fall, sponsored by Region Örebro County. Not yet recruiting. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-01-30.

Sponsored by Region Örebro County · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
80
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

People with multiple sclerosis (MS) have a higher fall risk compared to older people and to the general population. A meta-analysis reported that 56% of those with mild to moderate MS, fell at least once during a 3-month period. The risk of falling seems to peak when the walking distance starts to be affected and when walking aids are introduced and the walking distance is as short as 100 m. Previous studies have identified a number of fall risk factors, both relating to MS- symptoms and contextual factors. In a study published in 2025, we reported the complexity of fallsituations and the interaction between triggering factors, contextual factors and activities and circumstances that occurred before the fall incidents . The symptoms when having MS varies between individuals as well as over time. I the planned randomised, controlled multicenter study we move forward, producing individual fallrisk analyses based upon the findings from the study published in 2025, and offer individual strategies. This has not been studied before. All participants will receive general information on how fall risk can be prevented. Those randomised to control group will be offered the intervention after ending of the study. The study will be conducted in two phases starting with an internal pilot study followed by a full scale randomized controlled trial (RCT).

Read the detailed description

The intervention will be based on previous findings i. e., fall risk factors related to the International Classification of Functioning, Disability and Health and is an add-on intervention to a general fall risk information.

02

Conditions studied

  • Multiple Sclerosis
  • Fall

Browse trials for

Keywords

  • falls
  • prevention
03

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Diagnosed with MS
  • Affected ability to walk du to MS according to the participant
  • At least one self-reported fall the last 3 months due to MS according to the participant

Exclusion criteria

Exclusion Criteria:

  • Unable to walk 100m even with walking device and/or pauses.
  • Apparently affected walking ability due to other conditions such as for example orthopedic or other neurological diseases.
  • Difficulty to answer questionnaires written in Swedish
04

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Investigator, Outcomes assessor)
Enrollment
80 participants (estimated)

Study arms

  • Experimental
    Intervention group

    This arm will receive an individual analyses of current fall situations and a tailored individual strategy aiming to reduce fall frequency

    Behavioral: Individual strategies

  • No intervention
    Control group

    This arm will only receive general advice. Will be offered the intervention after ending of the study period

Interventions

  • BehavioralIndividual strategies

    This arm will receive an individual analyses of current fall situations and a tailored individual strategy aiming to reduce fall frequency

05

What researchers measure

Primary outcomes

  1. Prospectively self-reported falls (rate, time to fall)

    Self-reported falls collected every two weeks during a 6-month period

    Time frame: every 14th day during 6 months

Secondary outcomes

  1. Falls-Efficacy Scale-International score

    16 questions regarding level of concern about falling. Scores for each item together adds up to a total that ranges as follows: 16 (no concerns about falling( to 28 (severe concern about falling

    Time frame: baseline and immediately after the intervention

  2. Activity-specific balance Confidence Scale score

    16 questions regarding confidence to remain balance during everyday activities scoring from 0 (no confidence) to 100 (full confidence)

    Time frame: baseline and immediately after the intervention

  3. Self-rated ability to reduce falls

    One question measured using a visual analogue scale 0 (no ability) to 100 (full ability)

    Time frame: baseline and immediately after the intervention

  4. Self-rated ability to understand one's own fall risk factors

    One question using a visual analogue scale 0 (no understanding) to 100 (full understanding)

    Time frame: baseline and immediately after the intervention

  5. Self-rated fear of falling reducing activities

    One question where the person rates whether fear of falling have made them do less activities compared to before (yes, no, don't know, prefer not to answer)

    Time frame: baseline and immediately after the intervention

  6. 12-item MS Walking scale score

    Measures self-rated affected walking ability due to MS using 12 items. A score is obtained by subtracting the minimum score possible (=12) from the achieved sum, dividing by the range (=48) and multiplying by 100. Higher scores indicate more limited walking ability

    Time frame: baseline and immediately after the intervention

Other outcomes

  1. Timed Up and Go test

    Measures basic mobility (time for rising up from a chair, walk 3m, turn around, walk back and sit down.

    Time frame: baseline

  2. Six Spot Step Test

    Measures speed, coordination and balance using time for a person to walk in zic-zac, kicking bricks using one foot for round one and the other foot for round two.

    Time frame: baseline

  3. Symbol Digit Modalities Test

    Screening test for cognitive function pairing geometric figures with 10 numbers. Number of right and wrong answers given during 90 seconds

    Time frame: baseline

  4. "Frändin Grimby" activity scale

    Measures physical activity the past 6 months using six alternatives ranging from hardly no physical activity to very hard physical activity

    Time frame: baseline and immediately after the intervention

  5. MS Impact Scale-29

    Measures self-rated physical and psychological MS-specific outcomes the past two weeks ranging from not at all to extremely. summing responses for its 20-item Physical Scale and 9-item Psychological Scale. The raw scores are transformed to a 0-100 scale, where higher scores indicate greater impact from the disease. The transformation for the Physical Scale is (100\*(observed score - 20)) / (100-20), and for the Psychological Scale is (100\*(observed score - 9)) / (45-9). A responder specific mean score can be calculated from completed items if at least 50% of the items in a scale are answered.

    Time frame: baseline

06

Study locations

No study locations are listed for this record.

07

References and documents

Publications

  • Salari N, Darvishi N, Ahmadipanah M, Shohaimi S, Mohammadi M. Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2022 Jun 28;17(1):334. doi: 10.1186/s13018-022-03222-1. PubMed 35765037 ↗
  • Mazumder R, Murchison C, Bourdette D, Cameron M. Falls in people with multiple sclerosis compared with falls in healthy controls. PLoS One. 2014 Sep 25;9(9):e107620. doi: 10.1371/journal.pone.0107620. eCollection 2014. PubMed 25254633 ↗
  • Nilsagard Y, Gunn H, Freeman J, Hoang P, Lord S, Mazumder R, Cameron M. Falls in people with MS--an individual data meta-analysis from studies from Australia, Sweden, United Kingdom and the United States. Mult Scler. 2015 Jan;21(1):92-100. doi: 10.1177/1352458514538884. Epub 2014 Jun 16. PubMed 24948687 ↗
  • Gunn HJ, Newell P, Haas B, Marsden JF, Freeman JA. Identification of risk factors for falls in multiple sclerosis: a systematic review and meta-analysis. Phys Ther. 2013 Apr;93(4):504-13. doi: 10.2522/ptj.20120231. Epub 2012 Dec 13. PubMed 23237970 ↗
  • Carling A, Forsberg A, Nilsagard Y. Falls in people with multiple sclerosis: experiences of 115 fall situations. Clin Rehabil. 2018 Apr;32(4):526-535. doi: 10.1177/0269215517730597. Epub 2017 Sep 13. PubMed 28901164 ↗
  • Nilsagard Y, Lundholm C, Denison E, Gunnarsson LG. Predicting accidental falls in people with multiple sclerosis -- a longitudinal study. Clin Rehabil. 2009 Mar;23(3):259-69. doi: 10.1177/0269215508095087. PubMed 19218300 ↗
  • Gunn H, Creanor S, Haas B, Marsden J, Freeman J. Risk factors for falls in multiple sclerosis: an observational study. Mult Scler. 2013 Dec;19(14):1913-22. doi: 10.1177/1352458513488233. Epub 2013 Apr 30. PubMed 23633067 ↗
  • Waneskog AH, Forsberg AS, Nilsagard YE. Exploring the Complexity of Falls in People With Multiple Sclerosis: A Qualitative Study. Int J MS Care. 2024 Nov 5;26(Q4):308-314. doi: 10.7224/1537-2073.2024-020. eCollection 2024 Oct. PubMed 39502367 ↗
  • Nilsagard Y, Udumyan R, Halleberg Nyman M, Waneskog A. Individually designed fall prevention strategies compared to generic strategies for mastering complex fall risk situations in people with multiple sclerosis: study protocol of a randomised controlled trial. BMJ Open. 2026 Jul 15;16(7):e115430. doi: 10.1136/bmjopen-2025-115430. PubMed 42457429 ↗

Study documents

  • Protocol and statistical analysis plan · Dec 8, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Yes — We aim to publish a study protocol that includes a full description of the study

Supporting information: Study protocol, Sap

08

Registry details

Key details

Study ID
NCT07378566
Lead sponsor
Region Örebro County
Collaborators
Institution of Medical Sciences, Örebro University, Region Gävleborg, Region Västmanland, Sormland County Council, Sweden
Responsible party
Ylva Nilsagard (Research leader Integrated care, Region Örebro County) — Principal investigator
First posted
Jan 30, 2026
Start date
Jan 1, 2026 (estimated)
Primary completion
Jul 31, 2028 (estimated)
Completion
Dec 31, 2028 (estimated)
Last update
Jan 30, 2026

Study contacts

Ylva E Nilsagård, Ass. prof
Contact
ylva.nilsagard@regionorebrolan.se
+46 070 609 37 37
Anna Wäneskog, PhD
Contact
anna.waneskog@regionvastmanland.se
+460 021-175972
Ylva E Nilsagård, Ass. prof
principal investigator · University Healthcare Research Center, Faculty of Medicine and Health

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is not yet recruiting, as verified in Nov 2025. You cannot join it, but the record below documents what was studied.

Follow this study

Get an email when the registry record changes — status, dates, results — or when someone posts here.

Sign in to follow

Discussion

Questions and observations about this study, from anyone following it. Not medical advice, and not a channel to the study team — their contact details are on the registry record.

Sign in to join the discussion. Reading takes no account; posting does. You choose a display name, and a pseudonym is the default.

Nothing here yet. If you are running this trial, taking part in it, or weighing whether to, this is the place to say so.

Start the discussion