Research square · 2026
Learning Beyond the Clinic: Can Point of Choice Visual Feedback Prompts Elicit Motor Behavior Changes in Persons with Multiple Sclerosis?
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Fox Samantha R, Jangraw David C, Mascia Guido, Gurchiek Reed D, Feng Yuanyuan, Meyer Brett M, Solomon Andrew J, McGinnis Ellen W, McGinnis Ryan S
Аннотация
BACKGROUND: Falls are common in persons with multiple sclerosis (PwMS), and their consequences further undermine their quality of life. Current fall prevention interventions fail to address real-time stability challenges that may occur during cognitively complex daily activities. This need may be fulfilled by means of just-in-time interventions that leverage prompts delivered via a mobile app, having the aim of producing beneficial targeted biomechanical changes.
METHODS: Fourteen ambulatory PwMS completed multiple Timed Up-and-Go tests under cognitive load across two different visits. Two visual feedback prompts targeting trunk flexion during sit-to-stand transitions (STS-TF) and stance width (SW) during gait were delivered terminally via ab ad hoc designed app, the Just in Time Fall Prevention app. Linear mixed-effects models with Dunnett's correction were implemented to evaluate prompt-induced changes relative to baseline.
RESULTS: Prompts were successfully able to systematically reduce STS-TF by 7.1° (p < 0.001, d = - 0.483) and to increase SW by 8.1 mm (p = 0.021, d = 0.259). The majority of participants reported willingness to use the app with and without physician prescription (95% and 68%, respectively).
CONCLUSION: This study demonstrated for the first time that PwMS can produce targeted biomechanical adaptations in response to point-of-choice visual feedback prompts delivered by a mobile app, supporting that just-in-time mobile interventions as a proactive fall prevention strategy.
METHODS: Fourteen ambulatory PwMS completed multiple Timed Up-and-Go tests under cognitive load across two different visits. Two visual feedback prompts targeting trunk flexion during sit-to-stand transitions (STS-TF) and stance width (SW) during gait were delivered terminally via ab ad hoc designed app, the Just in Time Fall Prevention app. Linear mixed-effects models with Dunnett's correction were implemented to evaluate prompt-induced changes relative to baseline.
RESULTS: Prompts were successfully able to systematically reduce STS-TF by 7.1° (p < 0.001, d = - 0.483) and to increase SW by 8.1 mm (p = 0.021, d = 0.259). The majority of participants reported willingness to use the app with and without physician prescription (95% and 68%, respectively).
CONCLUSION: This study demonstrated for the first time that PwMS can produce targeted biomechanical adaptations in response to point-of-choice visual feedback prompts delivered by a mobile app, supporting that just-in-time mobile interventions as a proactive fall prevention strategy.