Skip to content

Research at St Andrews

Balance Right in Multiple Sclerosis (BRiMS): a feasibility randomised controlled trial of a falls prevention programme

Research output: Contribution to journalArticlepeer-review


H. Gunn, K. N. Stevens, S. Creanor, J. Andrade, L. Paul, L. Miller, C. Green, P. Ewings, A. Barton, M. Berrow, J. Vickery, B. Marshall, J. Zajicek, J. A. Freeman

School/Research organisations



Balance, mobility impairments and falls are problematic for people with multiple sclerosis (MS). The “Balance Right in MS (BRiMS)” intervention, a 13-week home and group-based exercise and education programme, aims to improve balance and minimise falls. This study aimed to evaluate the feasibility of undertaking a multi-centre randomised controlled trial and to collect the necessary data to design a definitive trial.


This randomised controlled feasibility study recruited from four United Kingdom NHS clinical neurology services. Patients ≥ 18 years with secondary progressive MS (Expanded Disability Status Scale 4 to 7) reporting more than two falls in the preceding 6 months were recruited. Participants were block-randomised to either a manualised 13-week education and exercise programme (BRiMS) plus usual care, or usual care alone.

Feasibility assessment evaluated recruitment and retention rates, adherence to group assignment and data completeness. Proposed outcomes for the definitive trial (including impact of MS, mobility, quality of life and falls) and economic data were collected at baseline, 13 and 27 weeks, and participants completed daily paper falls diaries.


Fifty-six participants (mean age 59.7 years, 66% female, median EDSS 6.0) were recruited in 5 months; 30 randomised to the intervention group. Ten (18%) participants withdrew, 7 from the intervention group. Two additional participants were lost to follow up at the final assessment point. Completion rates were > 98% for all outcomes apart from the falls diary (return rate 62%).

After adjusting for baseline score, mean intervention—usual care between-group differences for the potential primary outcomes at week 27 were MS Walking Scale-12v2: − 7.7 (95% confidence interval [CI] − 17.2 to 1.8) and MS Impact Scale-29v2: physical 0.6 (CI − 7.8 to 9), psychological − 0.4 (CI − 9.9 to 9). In total, 715 falls were reported, rate ratio (intervention:usual care) for falls 0.81 (0.41 to 2.26) and injurious falls 0.44 (0.41 to 2.23).


Procedures were practical, and retention, programme engagement and outcome completion rates satisfied a priori progression criteria. Challenges were experienced in completion and return of daily falls diaries. Refinement of methods for reporting falls is therefore required, but we consider a full trial to be feasible.

Trial registration




Original languageEnglish
Article number2
JournalPilot and Feasibility Studies
Issue number1
Publication statusPublished - 4 Jan 2021

    Research areas

  • Secondary progressive multiple sclerosis, Exercise, Self-management, Mobility, Accidental falls, Balance, Quality of life, Feasibility randomised controlled trial

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Simvastatin as a neuroprotective treatment for Parkinson's disease (PD STAT): protocol for a double-blind, randomised, placebo-controlled futility study

    Carroll, C. B., Webb, D., Stevens, K. N., Vickery, J., Eyre, V., Ball, S., Wyse, R., Webber, M., Foggo, A., Zajicek, J., Whone, A. & Creanor, S., 7 Oct 2019, In: BMJ Open. 9, 10, 11 p., e029740.

    Research output: Contribution to journalArticlepeer-review

  2. Assessment of a home-based standing frame programme in people with progressive multiple sclerosis (SUMS): a pragmatic, multi-centre, randomised, controlled trial and cost-effectiveness analysis

    Freeman, J. A., Hendrie, W., Jarrett, L., Hawton, A., Barton, A., Dennett, R., Jones, B., Zajicek, J. P. & Creanor, S., Aug 2019, In: Lancet Neurology. 18, 8, p. 736-747

    Research output: Contribution to journalArticlepeer-review

  3. A self-management programme to reduce falls and improve safe mobility in people with secondary progressive MS: the BRiMS feasibility RCT

    Gunn, H., Andrade, J., Paul, L., Miller, L., Creanor, S., Stevens, K., Green, C., Ewings, P., Barton, A., Berrow, M., Vickery, J., Marshall, B., Zajicek, J. P. & Freeman, J., 1 Jun 2019, In: Health Technology Assessment. 23, 27, p. 1-166

    Research output: Contribution to journalArticlepeer-review

  4. Machine-learning based identification of undiagnosed dementia in primary care: a feasibility study

    Jammeh, E. A., Carroll, C. B., Pearson, S. W., Escudero, J., Anastasiou, A., Zhao, P., Chenore, T., Zajicek, J. & Ifeachor, E., 12 Jun 2018, In: BJGP Open. 2, 2, 13 p., bjgpopen18X101589.

    Research output: Contribution to journalArticlepeer-review

  5. Improving the quality of cognitive screening assessments: ACEmobile, an iPad-based version of the Addenbrooke's Cognitive Examination-III

    Newman, C. G. J., Bevins, A. D., Zajicek, J. P., Hodges, J. R., Vuillermoz, E., Dickenson, J. M., Kelly, D. S., Brown, S. & Noad, R. F., 2018, In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring. 10, p. 182-187 6 p.

    Research output: Contribution to journalArticlepeer-review

Related by journal

  1. A controlled pilot trial of a nurse-led intervention (Mini-AFTERc) to manage fear of cancer recurrence in patients affected by breast cancer

    McHale, C. T., Cruickshank, S., Torrens, C., Armes, J., Fenlon, D., Banks, E., Kelsey, T. & Humphris, G. M., 7 May 2020, In: Pilot and Feasibility Studies. 6, 10 p., 60.

    Research output: Contribution to journalArticlepeer-review

  2. A mixed-methods feasibility study protocol to assess the communication behaviours within the dental health professional-parent-child triad in a general dental practice setting

    Yuan, S., Humphris, G., Ross, A., MacPherson, L., Zhou, Y. & Freeman, R., 13 Aug 2018, In: Pilot and Feasibility Studies. 4, 9 p., 136.

    Research output: Contribution to journalArticlepeer-review

ID: 272576701