The Balance Right in Multiple Sclerosis (BRiMS) feasibility randomised controlled trial: participant summary
What is the BRiMS feasibility trial?
BRiMS is a guided self-management programme to reduce falls and improve quality of life, balance and mobility in people with secondary progressive Multiple Sclerosis. Before testing the effectiveness of BRiMS in a large-scale trial, we needed to run a small-scale version to check that the programme and trial methods were feasible.
What did we do?
- We recruited 56 people with secondary progressive MS, aged 34-81.
- Thirty-six lived in the South West of England and 20 in Ayrshire.
- Half of the people in each region (selected at random) did the BRiMS programme, which included two one-to one sessions with a physiotherapist, a home programme (supported by a website and programme manual) and three group sessions.
- People in the BRiMS group were asked to do two hours of balance exercise per week, and to consider how they could reduce their risk of falling at home, supported by guided activities. Those in the control group continued with their usual care.
- Questionnaires were used to ask people about their mobility, falls and quality of life, we measured their balance and activity levels, and collected information about costs. We did this three times: at the beginning of the study, after 15 weeks and at the end (27 weeks). We also asked people to fill in a paper diary every day throughout the study to tell us about any falls, injuries and other problems they had.
- We interviewed 13 people (10 people from the BRiMS group and three people from the control group), and the four physiotherapists who ran the programmes to tell us their experiences of being in the trial.
What did we find?
- At the end of the study we were able to review 44 people. The key measures were completed by 98% of those we assessed, but only around half of the diaries detailing falls were returned. As this was a feasibility trial, the numbers were too small to look at differences between the groups.
- Participants liked the BRiMS programme; some did a lot of exercise and learning activities, but most did not manage the amount we asked them to do.
- People reported feeling a little overwhelmed by the educational content of BRiMS, and that this should be reduced in future. They told us that they felt their balance had improved and fell less after the BRiMS programme.
- Our assessment of the trial methods we used showed it would be possible to run a full-scale trial using this design, but that we need to adapt the BRiMS programme to make it more user-friendly.
Quotes from our participants
An enormous thank you to everyone who contributed to the success of this trial. This includes participants, research team members, therapists and all those who supported funding, recruitment and management of the trial.