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

January 22, 2026 updated by: Ylva Nilsagard, Region Örebro County

Digitally Supported Intervention to Master Complex Fall Risk Situations in Persons With Multiple Sclerosis - a Multicenter Study (STAR)

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).

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

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.

Study Type

Interventional

Enrollment (Estimated)

80

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact Backup

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

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:

  • 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

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
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
This arm will receive an individual analyses of current fall situations and a tailored individual strategy aiming to reduce fall frequency
No Intervention: Control group
This arm will only receive general advice. Will be offered the intervention after ending of the study period

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Prospectively self-reported falls (rate, time to fall)
Time Frame: every 14th day during 6 months
Self-reported falls collected every two weeks during a 6-month period
every 14th day during 6 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Falls-Efficacy Scale-International score
Time Frame: baseline and immediately after the intervention
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
baseline and immediately after the intervention
Activity-specific balance Confidence Scale score
Time Frame: baseline and immediately after the intervention
16 questions regarding confidence to remain balance during everyday activities scoring from 0 (no confidence) to 100 (full confidence)
baseline and immediately after the intervention
Self-rated ability to reduce falls
Time Frame: baseline and immediately after the intervention
One question measured using a visual analogue scale 0 (no ability) to 100 (full ability)
baseline and immediately after the intervention
Self-rated ability to understand one's own fall risk factors
Time Frame: baseline and immediately after the intervention
One question using a visual analogue scale 0 (no understanding) to 100 (full understanding)
baseline and immediately after the intervention
Self-rated fear of falling reducing activities
Time Frame: baseline and immediately after the intervention
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)
baseline and immediately after the intervention
12-item MS Walking scale score
Time Frame: baseline and immediately after the intervention
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
baseline and immediately after the intervention

Other Outcome Measures

Outcome Measure
Measure Description
Time Frame
Timed Up and Go test
Time Frame: baseline
Measures basic mobility (time for rising up from a chair, walk 3m, turn around, walk back and sit down.
baseline
Six Spot Step Test
Time Frame: baseline
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.
baseline
Symbol Digit Modalities Test
Time Frame: baseline
Screening test for cognitive function pairing geometric figures with 10 numbers. Number of right and wrong answers given during 90 seconds
baseline
"Frändin Grimby" activity scale
Time Frame: baseline and immediately after the intervention
Measures physical activity the past 6 months using six alternatives ranging from hardly no physical activity to very hard physical activity
baseline and immediately after the intervention
MS Impact Scale-29
Time Frame: baseline
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.
baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Region Örebro County

Collaborators

Region Gävleborg
Region Västmanland
Sormland County Council, Sweden
Institution of Medical Sciences, Örebro University

Investigators

  • Principal Investigator: Ylva E Nilsagård, Ass. prof, University Healthcare Research Center, Faculty of Medicine and Health

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

January 1, 2026

Primary Completion (Estimated)

July 31, 2028

Study Completion (Estimated)

December 31, 2028

Study Registration Dates

First Submitted

September 3, 2025

First Submitted That Met QC Criteria

January 22, 2026

First Posted (Actual)

January 30, 2026

Study Record Updates

Last Update Posted (Actual)

January 30, 2026

Last Update Submitted That Met QC Criteria

January 22, 2026

Last Verified

November 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 285079

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

We aim to publish a study protocol that includes a full description of the study

IPD Sharing Time Frame

Study protocol and Statistical Analysis plan before study start.

IPD Sharing Access Criteria

Open access if accepted for publication

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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