Feasibility aspect | Summary of responses | Consideration |
---|---|---|
Study procedures | ||
Accuracy of information and communication about intervention and study procedures | All participants reported that information and communication corresponded with their experiences of the intervention and study procedures or that they had been pleasantly surprised about the difficulty and challenge level of the exercises in the intervention. | Feasible |
Inclusion and exclusion assessment | The inclusion assessment with the Expanded Disability Status Scale and the exclusion assessment with the Montreal Cognitive Assessment were considered feasible. | Feasible |
Assessment of demographic and clinical characteristics | Baseline data collection through semi-structured interview was considered feasible. | Feasible |
Acceptability of time required for assessment procedures | Time required for the baseline and follow-up assessments at Karolinska Institutet were considered acceptable. | Feasible |
Blood-sampling procedure | Sampling of blood was feasible. | Feasible |
Attitude towards long-term follow-up assessments | All participants reported that they are likely to participate in long-term follow-up measurements up to 6 months post-intervention. | Feasible |
Intervention delivery | ||
Training session time of day and weekly frequency | Several training sessions available, enabling the participants to choose session time and weekly frequency themselves, contributed to feasibility. | Feasible |
Duration of training session | Training sessions of 60 min were feasible for most participants since the time spent on transport also needed to be considered. A few expressed a wish for longer sessions. | Feasible |
Individual adjustment of exercises related to intervention progression | Initially, more careful guidance on how exercises could be adapted was required but participants gradually became more confident in adjusting the exercises themselves. | Feasible |
Individual adjustment of challenge level across the progression blocks | The progression blocks were considered supportive to stimulate progression and create new challenges. The participants could gradually, through increased awareness and knowledge of their own ability, adjust progression and challenge level themselves. Guidance by the trainers was required to calibrate the exercise complexity and to suggest rest when needed. | Feasible |
Individual adjustment of exercises related to disability level and variation in daily capacity | Initially, some participants reported the exercise challenge level to be somewhat low in relation to their own disability level, but the appropriate challenge level could subsequently be implemented. Individual adjustments related to variation in daily capacity were considered throughout the intervention period, which made exercises easier or more difficult, i.e., the challenge level was altered. | Feasible |
Monitoring of level of challenge | The rating scale for assessment of challenge level in the balance training was reported to be comprehensible and easy-to-use. It was perceived easier to rate specific exercises than to make an overall assessment of the challenge level for an entire balance training session. | Feasible |
Group training despite divergence in level of overall MS disability | Variations in overall MS disability between participants was perceived as a source of inspiration rather than a disadvantage as it contributed to reflection and new perspectives. | Feasible |
Individual balance exercises | The individual balance exercises were considered relevant and useful where individual adjustment of challenge level specifically related to individual disabilities could be in focus. | Feasible |
Safety in training | The intervention was perceived to be safe. Falling was considered a part of the risk when participating in a highly challenging balance intervention. | Feasible |
Home exercise program as substitute for group training session | Training at home was considered a possible supplement, but could not replace guided group training sessions; the high intensity and challenge level carried out during training sessions could not be reached at home, and exercise equipment was not available. | Feasible but not requested |
Individual effort required for participation | A majority of the participants stated a need to refrain from other activities (e.g., rearrangement of work and family activities) in order to be able to prioritize the intervention, since their regular schedule was full. | Feasible |
Motivation in training | All participants reported feeling motivated to participate in the intervention. Factors contributing to motivation were the increased awareness and knowledge of their own balance capacity, which was accomplished through feedback given by the trainers and peer participants. | Feasible |
Perceived intervention effect on balance control | Perceived effects of the intervention were increased safety and improved balance control or maintained balance control if an ongoing deterioration in physical status was present. Examples of enhanced confidence were climbing stairs without a handrail or walking on slippery or uneven surfaces. | Feasible |
Potential outcome measures | ||
Assessment of primary and secondary outcomes | Mini-BESTesta | Feasible |
10-meter walk testa | ||
2-minute walk testa | ||
APDMb Gait analysis (spatial and temporal gait parameters) | ||
APDMb Sway test | ||
Six Spot Step Testa | ||
Multiple Sclerosis Walking Scalea | ||
Falls Efficacy Scale Internationala | ||
Frenchay Activities Index | ||
Multiple Sclerosis Impact Scale-29a | ||
Modified Fatigue Impact Scalea | ||
Hospital Anxiety and Depression Scale | ||
EuroQol 5D (Index and Visual Analog Scalea) | ||
Life Satisfaction Scale | ||
Acceptance of Chronic Health Condition Scale | ||
Trail Making Testa | ||
Ray Auditory Verbal Learning Testa | ||
Symbol Digit Modalities Testa | ||
Immunological markers in blood |