Trial results for protective step training in Multiple Sclerosis were posted on ClinicalTrials.gov on 2025-06-10. The training demonstrated a statistically significant reduction in reactive step latency in the MS group, with a mean difference of -0.041 seconds (p=0.012).
Background
Falls are a common and serious concern for individuals with Multiple Sclerosis (MS), particularly among Veterans. Existing rehabilitation strategies aimed at reducing falls in this population have shown limitations. Protective step training, which involves controlled exposure to repeated "slips" to improve reactive balance, has proven effective in reducing falls in older adults. This trial aimed to investigate whether a similar approach could improve postural control and reduce fall risk in people with MS.
Trial design
This completed study, designated as Phase NA, enrolled a total of 57 participants diagnosed with Multiple Sclerosis. The trial investigated the effects of protective step training. While specific primary outcomes were not listed, the study assessed various measures of postural control and cognitive function. The study design included a "Step Training (MS Group)" and a "Step Training (Control Group)" for comparison.
Key results
The trial reported several key measurements and analyses:
- Training-related Change in Margin of Stability:
- For the Step Training (MS Group), the mean change was 0.0289 meters (Standard Deviation 0.0777).
- For the Step Training (Control Group), the mean change was 0.0217 meters (Standard Deviation 0.119).
- Symbol Digit Modality Test:
- For the MS Group, the mean score was 42.44 Units on a scale (Standard Deviation 10.33).
- For the Step Training (Control Group), the mean score was 51.88 Units on a scale (Standard Deviation 8.44).
- Training-related Changes in Reactive Step Length:
- For the Step Training (MS Group), the mean change was 0.026 meters (Standard Deviation 0.086).
- For the Step Training (Control Group), the mean change was 0.023 meters (Standard Deviation 0.063).
- Training-related Change in Reactive Step Latency:
- For the Step Training (MS Group), the mean change was -0.0414 seconds (Standard Deviation 0.1047).
- For the Step Training (Control Group), the mean change was 0.0047 seconds (Standard Deviation 0.0500).
Key analyses revealed:
- A linear regression analysis assessing immediate improvements in the MS group reported a mean difference of 0.029 (95.0% CI: 0.002 to 0.056) with a p-value of 0.036.
- A Spearman correlation between cognition (SDMT) and improvement in margin of stability yielded a Spearman's Rho of 0.019 and a p-value of 0.92, indicating no significant correlation.
- A linear regression analysis for the change in reactive step length in the MS group showed a mean difference of 0.026 (95.0% CI: -0.007 to 0.059) with a p-value of 0.119.
- A linear regression analysis for the change in reactive step latency in the MS group demonstrated a mean difference of -0.041 (95.0% CI: -0.073 to -0.009) with a statistically significant p-value of 0.012.
What this means
The results suggest that protective step training may offer a tangible benefit for individuals with Multiple Sclerosis by improving their reactive balance responses. The statistically significant reduction in reactive step latency (-0.041 seconds, p=0.012) indicates that participants in the MS group were able to initiate a protective step more quickly after training. Additionally, the finding of "immediate improvements" (p=0.036) further supports the potential of this training to enhance postural control. These findings are particularly relevant given the high risk of falls in the MS population and the current limitations of existing rehabilitation approaches.
Source
The information for these trial results was obtained from ClinicalTrials.gov, a public database of clinical studies. The results for the study NCT03551665, titled "Protective Stepping in People With MS", were posted on 2025-06-10 on clinicaltrials.gov.