Deirdre Phelan is one of hundreds benefitting from a pioneering pilot online exercise programme that has helped reduce the risk of falls and fractures and related surgeries in the hope of easing pressures on the health service.
The 56-year-old, a mother of three from Co Meath, was diagnosed with multiple sclerosis (MS) in 2011 after she suffered a number of falls, leaving her feeling isolated and requiring a wheelchair or walking aid to get around.
Ms Phelan’s condition manifested in “foot drop”, whereby her toes would catch in the ground during her stride and lead to her falling.
“On two occasions I cut my head and ended up having to get stitches,” she says.
Ms Phelan believes participating in the Active Neuro Project, an online physiotherapy and exercise initiative run by MS Ireland and funded by the Sláintecare Integration Fund, has made "a huge difference psychologically and physically".
“This balance programme looks at why you are falling, so we analyse this, and how would you prevent [falls] in the future. People might have issues with eyesight, in my case it’s foot drop, and fatigue would also be a contributing factor,” she says.
“There is also a psychological impact of falling, it affects your confidence and makes you reluctant to do other things, it draws people back into themselves.”
As well as providing exercise and tips on better balance, the online classes allow participants to share their experiences.
Face-to-face classes run by MS Ireland were cancelled due to Covid-19, but some participants see the online model as reducing stress and fatigue levels for participants, who no longer have to organise transport.
“I would say it has made a huge difference because I’m sure at this stage, two years into this pandemic, I probably wouldn’t still be doing exercises if there wasn’t somebody driving this. There’s nothing like doing it together because there is someone encouraging you,” says Ms Phelan, who believes her muscles would have “seized up” but for the online sessions.
“Absolutely, that’s what happens, you use it or lose it, that’s my motto.”
Prof Susan Coote, of University of Limerick and MS Ireland, who runs the classes for people with neurological conditions, has taken on 229 referrals since 2020, three-quarters of which involve people with MS and Parkinson's disease.
“There were 39 fallers pre-intervention and this reduced significantly to 20 after the intervention, and the number of falls reduced from 276 to 192,” Prof Coote said.
“Reducing falls and associated injuries is an extremely positive outcome that has the potential to reduce personal factors such as injury, fear of falling and activity curtailment, and also societal costs such as inpatient and outpatient visits, increased needs for care and increased numbers of days off work.”
Active Neuro is one of 48 programmes delivered by MS Ireland to 340 participants, with 87.6 per cent of participants showing improved or maintained fatigue levels and 86.3 per cent demonstrating improved or maintained balance and strength levels.
“There was also a significant reduction in A&E and inpatient services utilisation, reducing from 24 to 16 people and from 122 to 52 days. In total, 43.1 per cent [of participants] reduced their usage of healthcare services after our programmes,” Prof Coote said.
“The online platform meant that location was no longer an issue, and by recruiting nationally we were able to create groups of people with similar needs and abilities and deliver really specific and hence effective physiotherapy treatments.”
Prof Coote explained that in any three-month period “over 50 per cent of people with MS will fall, which is similar to the falls rates of people over the age of 85”.
“Our programme teaches people how to analyse their falls and what caused it and gives them management strategies to prevent future falls.”