A new study has shown that people in the advanced stage of multiple sclerosis (MS) experience significant improvements in movement and balance thanks to a specialised standing frame.
Sponsored by University Hospitals Plymouth NHS Trust and published last week in Lancet Neurology, the study in people with progressive MS also showed that the intervention appeared cost-effective, leading researchers to conclude that it could be routinely implemented within MS care throughout the UK.
Around 110,000 people in the UK have MS; a lifelong condition that affects the central nervous system (the brain and spinal cord) and often leads to increasing disability.
The study, called Standing Up in Multiple Sclerosis (SUMS), was funded by the National Institute for Health Research (NIHR) Research for Patient Benefit Programme and led by the University of Plymouth.
John Kendrick from Sparkwell near Plymouth, Devon was assigned the standing frame intervention and, after years of not being able to move a great distance, was able to walk his daughter down the aisle on her wedding day.
He said: “There is absolutely no doubt in my mind that had it not been for the standing frame, I would not have been able to walk my daughter into church to marry her husband. It was a challenge, using a crutch to help me and obviously holding on to her too, but I’m so proud I did it.
“With secondary progressive MS, my mobility has decreased and I’m starting to lose feeling in my right hand. But the standing frame, which I’m continuing to use, has helped to keep me mobile.”
What is progressive MS?
Progressive MS often follows an earlier relapsing remitting stage, with the majority of people in the later stage experiencing walking difficulties, along with poor balance and co-ordination. As a result, many people spend much or all of their day sitting, which can lead to problems such as muscle weakness from disuse, pain, constipation, loss of movement at joints and pressure ulcers.
What does the standing frame do?
The Oswestry standing frame is designed to help slow the development of these problems in people in the more advanced stages of the condition, by enabling them to regularly stand and carry out strengthening and balance exercises in a supported position, with the help of a friend or family member if needed.
What did the study involve?
The nationwide study saw 71 people with the condition randomly allocated to undertake the standing frame programme over 20 weeks, alongside their usual care. Another 69 participants were randomly allocated to their usual care for the same time period and did not use the standing frame.
The intervention consisted of two home-based physiotherapy sessions (60 minutes each) to set up the standing programme, supported by six follow-up telephone calls. Participants were asked to stand for 30 minutes, three times weekly, over 20 weeks, with encouragement to continue for 36 weeks and beyond, although no further physiotherapy support was provided.
What did the results show?
Results showed that, on average, people who used the standing frame scored more highly on an assessment of their movement and balance function, as objectively assessed by a physiotherapist.
On average the intervention costs around £800, so the use of the standing frame also appeared to be cost-effective according to the criteria set out by The National Institute for Health and Care Excellence (NICE). This is an important factor when considering new interventions for use in the NHS.
In addition, participants assigned to the standing frame intervention reported experiencing personal improvements in their quality of life, such as their ability to balance and move about, reduced stiffness in their legs, and improved bladder and bowel control.
To find out more about the study, visit the SUMS website https://web-dr.tis.plymouth.ac.uk/research/sums