Editor's view

In the article, the author discusses the challenges in the decision making and advance care planning on critical care admission of patients living with dementia. Also cited are the poor understanding of the public of critical care, the effectiveness of using natural language processing of unstructured records and machine learning to identify those at risk of subsequent falls, and the recommended fall prevention strategies like Tai Chi.

Falls Among Older Adults During the COVID-19 Pandemic Compared to a Pre-pandemic Period: A Case-Control Study.

BACKGROUND: Little is known about how the COVID-19 pandemic impacted older adults admitted to the hospital with fall-related injuries. This research sought to determine if there was a difference in patient characteristics and hospital outcomes among older adults with fall-related injuries during the COVID-19 pandemic compared to a non-pandemic period. METHODS: A retrospective chart review of patients 65 years or older admitted for traumatic falls before and during COVID-19 was undertaken. Data abstracted included demographics, fall details, injury data, and hospital course. RESULTS: Of 1598 patients, 50.5% presented during COVID-19 (cases), and 49.5% presented pre-pandemic (controls). Fewer cases fell in rural areas (28.6% vs 34.1%, P = .018) and were transferred from outside hospitals (32.1% vs 38.2%, P = .011). More cases experienced alcohol (4.6% vs 2.4%, P = .017) and substance use disorders (1.4% vs .4%, P = .029). Fewer cases had subdural hemorrhages (11.8% vs 16.4%, P = .007), and more had pneumothoraxes (3.5% vs 1.8%, P = .032). More patients admitted during COVID-19 experienced acute respiratory failure (2.0% vs .0%, P < .001), hypoxia (1.5% vs .3%, P = .005), and delirium (6.3% vs 1.0%, P < .001). Fewer cases were discharged to skilled nursing facilities (50.8% vs 57.3%, P = .009) and more to home with services (13.1% vs 8.3%, P = .002). DISCUSSION: This study suggested there was a similar frequency of presentation for falls among older adults during the two study periods. Older adults with fall-related injuries experienced differences in presenting comorbidities, injury patterns, complications, and discharge locations during the study periods.

Factors associated with falls during voluntary self-isolation among community-dwelling older people: a longitudinal study.

[Purpose] We aimed to explore the factors that predict falls in community-dwelling older people over 6 months during their voluntary self-isolation for the coronavirus disease (SARS-CoV-2). [Participants and Methods] In this longitudinal study, we surveyed older people aged ≥65 years living in Takasaki City, Gunma Prefecture, using a questionnaire. We investigated the relationship between the frailty screening index and fall rate. [Results] A total of 588 older adults (response rate, 35.7%) filled and returned the questionnaire during the study period. Of these, 391 participants who had not applied for long-term care insurance and had completed the data on the response items were included in the study. Based on their responses in the survey questionnaire, 35 (8.95%) participants were grouped into the fall group and 356 into the non-fall group. Subsequently, the "no" response to "Can you recall what happened 5 minutes ago?" and "yes" response to "Have you felt tired for no reason (in the past 2 weeks)?" were identified as the significant factors associated with falls. [Conclusion] It is important to pay attention to the subjective evaluation of patients' cognitive decline and fatigue to prevent falls owing to the implementation of SARS-CoV-2 countermeasures.

CHRONOFALLS: A multicentre nurse-led intervention in the chronoprevention of in-hospital falls in adults.

BACKGROUND: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls. METHODS: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021. RESULTS: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis. CONCLUSIONS: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies. TRIAL REGISTRATION: The project was registered on the Clinical Trials Registry NCT04367298 (29/04/2020).

Association of COVID-19 'circuit breaker' with higher rates of elderly trauma admissions.

Introduction: In December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) virus emerged and caused a worldwide pandemic, leading to measures being imposed by many countries to reduce its transmission. Singapore implemented the 'circuit breaker', which restricted all movements except for access to necessities and healthcare services. We aimed to investigate the impact of lockdown measures on the pattern of trauma and its effects. Methods: An observational, retrospective, single-centre descriptive study was conducted using the trauma registry in Singapore General Hospital. It included patients above 18 years old who presented to the emergency department with trauma and were subsequently admitted. Patients admitted from 1 February 2020 to 31 July 2020 and those admitted during the same timeframe in 2019 were studied. Subgroup analyses were performed for patients aged ≥65 years and those <65 years. Results: A total of 1,037 patients were included for analysis. A 17.6% increase in trauma presentations was seen from 2019 to 2020. Patients aged ≥65 years accounted for the rise in admissions. The predominant mechanism of injury was falls at home for older patients and vehicular accidents in patients <65 years. There were no significant differences in injury severity score, intensive care/high-dependency unit admission rates, length of stay, mortality rate, and subsequent need for inpatient rehabilitation. Conclusion: Our study provided information on differences in trauma presentations before and during the COVID-19 pandemic. Further studies are required to better inform on additional precautionary measures needed to reduce trauma and improve safety during future lockdowns and pandemics.

Developing the Patient Falls Risk Report: A Mixed-Methods Study on Sharing Falls-Related Clinical Information from Home Care with Primary Care Providers.

If interRAI home care information were shared with primary care providers, care provision and integration could be enhanced. The objective of this study was to co-develop an interRAI-based clinical information sharing tool (i.e., the Patient Falls Risk Report) with a sample of primary care providers. This mixed-methods study employed semi-structured interviews to inform the development of the Patient Falls Risk Report and online surveys based on the System Usability Scale instrument to test its usability. Most of the interview sample (n = 9) believed that the report could support patient care by sharing relevant and actionable falls-related information. However, criticisms were identified, including insufficient detail, clarity, and support for shared care planning. After incorporating suggestions for improvement, the survey sample (n = 27) determined that the report had excellent usability with an overall usability score of 83.4 (95% CI = 78.7-88.2). By prioritizing the needs of end-users, sustainable interRAI interventions can be developed to support primary care.

Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay.

We used the 2019-2021 U.S. National Health and Aging Trend Study (N = 3,063, age 70+) and multinomial logistic regression and generalized linear models with Poisson and log link to identify correlates of (1) recurrent falls (2 + falls) over 3 years (2019-2021); and (2) any subsequent fall among those who had a fall in 2019. We also examined the associations between falls and hospitalization in 2021. Results show that those with recurrent falls had greater physical/functional and psychological health problems in 2019, while single fallers over the 3 years were not significantly different from those without a fall. Exercise was associated with a lower likelihood of a subsequent fall among those who fell in 2019. Both a single fall and recurrent falls over the 3 years were associated with a higher risk of hospitalization in 2021. Multifactorial fall preventions including exercise and depression/anxiety treatment are needed to mitigate recurrent fall risks.

Physiotherapy in Neurological Conditions: AB No: 179: Is Assessment of Balance Important in SARS �CoV-2 Survivors before discharge?

Purpose: To emphasize the importance of Balance assessment as integral part of SARS SARS-CoV-2 rehabilitation so that a ‘'future pandemic” of falls can be prevented. Relevance: Balance assessment in acute-care setting can help prevent falls and subsequent consequences complication during the course of rehabilitation. Participants: SARS –CoV-2 recovered survivors (n=130), who were admitted for a minimum of 7 days and on O2 support. Methods: Institutional Ethic committee approval was obtained. Patients admitted to the hospital with a confirmed diagnosis of SARS-CoV-2 who were on O2 support and minimum duration of hospital stay>7 days were recruited for the study. Balance impairment was assessed using Tinette POMA and the obtained data was analyzed. Analysis: DescriptiveResults: A total of (n=130) patients were identified, 54 patients were at risk of falls, 36 were at high risk and 18 were at moderate risk of fall. In the results, there is a significant balance impairment in O2 dependent SARS-CoV-2 survivors. Conclusion: Balance Assessment should be included in SARS-CoV-2 survivors so that a tailored exercise prescription can be formulated that will not only enhance their functional activities but also reduce the risk of falls and may prevent further complications. Implications: Balance Assessment will help to identify the patient who are at high risk of falls and effective rehabilitation can be planned. Early detection of fall risk through balance assessment paves way for targeted, integrated intervention through a tailored exercise program based on the findings thus, reducing the burden of the patient and healthcare system in general.

A fall in isolation: reflection on a complex case

This case review focuses on a male patient who had fallen and was found to be profoundly hypothermic, with an altered level of consciousness and evidence of seizure activity. With multiple time-critical features, this clinical presentation was made particularly challenging by the presence of several human factors. A reflective model that considered these human factors in the context of the COVID-19 pandemic, when this incident occurred, was employed. Reflecting on this incident revealed how some subconscious (intuitive) thinking led to a degree of unconscious bias compounded by availability heuristics and human factors present. This meant that the author encountered difficulty when trying to obtain peripheral vascular access and, although several alternative interventions were identified, the majority of these were unavailable at the time and some would require a change to standard clinical practice for many paramedics. The only intervention that could have been used earlier in the management of this patient was rectal diazepam, but the need for this was removed by the patient's seizure activity self-terminating. Given the increasing prevalence of falls, social isolation, mental health problems, alcohol and substance misuse, especially in the pandemic, this type of case was unlikely to be an isolated event, strengthening the argument that the range of clinical interventions available to paramedics should be increased.

A case report of multiple sclerosis after COVID-19 infection: causality or coincidence?

Introduction: Since the declaration of COVID-19 pandemic, several cases of demyelination of both peripheral and central nervous systems have been reported. The association of viral infection and the development of CNS demyelination has long been studied, and this link has recently been reported following SARS-CoV-2 infection as well. Case report: We report a case of a 36-year-old male who developed CNS demyelinating disease, that fulfilled the diagnostic criteria of multiple sclerosis (MS), 2 months after laboratory-confirmed infection with SARS-CoV-2. Conclusion(s): To our knowledge, this is the second published case report of MS in association with COVID-19 infection, and the first case from Middle East and North Africa (MENA) region, adding to the growing literature of a probable causal relationship between SARS-CoV-2 infection and the development of MS.Copyright © 2021 The Author(s)

[Effect of COVID-19 lockdown on the incidence and severity of falls in institutionalized older people: A longitudinal study]. / Efecto del confinamiento por COVID-19 sobre la incidencia y gravedad de las caídas en personas mayores institucionalizadas: estudio longitudinal.

BACKGROUND: During the COVID-19 pandemic, virus contention measures such as strict confinement were declared in nursing homes. OBJECTIVE: To assess the impact of confinement on the incidence of falls and their associated factors in institutionalized older persons during the first year of the pandemic compared to the previous year. METHODS: A multicenter, comparative study was conducted between the pre-pandemic year (March 2019 to February 2020) and the first year (March 2020 to February 2021) in five nursing homes in Catalonia (Spain). The number of falls, date, placement and consequences were recorded, as well as sociodemographic and health information. A descriptive, bivariate and multivariate analysis was performed, calculating odds ratio (OR) with 95% confidence intervals and statistical significance of p<0.05. RESULTS: The sample consisted of 80 individuals, with a mean age of 84.4 years, 83.7% being women. In the first year of the pandemic, the number of falls per person increased by 0.21% (32.0% in rooms). In multivariate analysis of the pre-pandemic period, the risk of sarcopenia (OR = 4.02; 95% CI [1.09-14.82], p = 0.036) was a risk factor for falls independently of age and hypertension. In the first year of pandemic no statistically significant associated factors were found. CONCLUSIONS: In the first year of the COVID-19 pandemic, there was a 15.6% increase in falls and an 8.7% increase in the number of people who fell compared to the previous year. The falls' location changed from common areas to bedrooms and increased in severity, with a 10.1% increase in fractures. Older age, risk of sarcopenia and arterial hypertension were associated with falls during the pre-pandemic period.

Real World Evidence of Wearable Smartbelt for Mitigation of Fall Impact in Older Adult Care.

Structured Abstract Falls with major injuries are a devastating occurrence for an older adult with outcomes inclusive of debility, loss of independence and increased mortality. The incidence of falls with major injuries has increased with the growth of the older adult population, and has further risen as a result of reduced physical mobility in recent years due to the Coronavirus pandemic. The standard of care in the effort to reduce major injuries from falling is provided by the CDC through an evidence-based fall risk screening, assessment and intervention initiative (STEADI: Stopping Elderly Accidents and Death Initiative) and is embedded into primary care models throughout residential and institutional settings nationwide. Though the dissemination of this practice has been successfully implemented, recent studies have shown that major injuries from falls have not been reduced. Emerging technology adapted from other industries offers adjunctive intervention in the older adult population at risk of falls and major fall injuries. Technology in the form of a wearable smartbelt that offers automatic airbag deployment to reduce impact forces to the hip region in serious hip-impacting fall scenarios was assessed in a long-term care facility. Device performance was examined in a real-world case series of residents who were identified as being at high-risk of major fall injuries within a long-term care setting. In a timeframe of almost 2 years, 35 residents wore the smartbelt, and 6 falls with airbag deployment occurred with a concomitant reduction in the overall falls with major injury rate.

Implementing best practice occupational therapist-led environmental assessment and modification to prevent falls: A qualitative study of two regional and rural public health services in Australia.

BACKGROUND: Occupational therapist-led environmental assessment and modification (EAM) is effective in reducing falls for populations at high risk. Two regional and rural public health services in Queensland devised an implementation strategy to embed best practice occupational therapist-led EAM. METHODS: A qualitative study was conducted to compare the determinants of implementation success across the different health services, using the COM-B model of behaviour change. Six semi-structured interviews were completed with occupational therapists involved at each site, following 12 months of implementation. Interview data were triangulated with minutes from three combined site steering committee meetings, eight local steering committee meetings, and field notes. Thematic analysis was completed to compare barriers and facilitators to best practice uptake of EAM and differences in outcomes between the two sites. RESULTS: Both sites commenced implementation with similar states of capability and motivation. After 12 months, one site considered that practice change had been embedded as noted in steering committee minutes and comments; however, the other site observed limited progress. According to the COM-B analysis, opportunity (the factors that lie outside the individual's control) had a significant influence on how both sites were able to respond to the practice change and navigate some of the unexpected challenges that emerged, including the COVID-19 pandemic. Existing team structure, multiple responsibilities of key stakeholders, differences in access to resources, and lack of connection between complementary services meant that COVID-19 disruptions were only a catalyst for unveiling other systemic issues. CONCLUSION: This study highlights the power of external factors on influencing behaviour change for best practice implementation. Learnings from the study will provide deeper understanding of completing implementation projects in regional and rural contexts and support the future implementation of EAM in occupational therapy clinical settings.

Changes in fall rates from before to during the COVID-19 pandemic: Findings from the prospective AMBROSIA study.

BACKGROUND: COVID-19 social distancing policies resulted in reductions in community movement, however fall rates during this time have not been described. METHODS: This prospective study included adults ≥65 years old participating in the Ambulatory Blood Pressure in Older Adults (AMBROSIA) cohort and who completed ≥1 monthly falls calendar (August 2019-March 2021; n=250). Months were grouped to correspond to the fall 2020 phased re-opening (August-October) and the shelter-in-place policy during the winter 2020 surge (November-January) in Los Angeles, California and compared to the same months, one year earlier (i.e., before the pandemic). RESULTS: Participants had a mean (SD) age of 75.2 (6.1) years, 49.6% were White, and 53.2% were women. We obtained 2,795 falls calendars during follow-up. Overall, 110 (44.0%) participants reported a total of 421 falls (rate 15.1 per 100 calendar months). The highest monthly fall rate during the pandemic was 22.9 (95% CI 16.4-31.1) per 100 calendar-months in August 2020. The lowest fall rate during the pandemic was 8.6 (95% CI 3.5-17.8) per 100 calendar-months in February 2021. During the pandemic, fall rates in August, September, and October 2020 were higher than the previous year (rate ratio 1.8 [95% CI 1.1-2.9]) and fall rates in November and December 2020 and January 2021 were lower than the previous year (rate ratio 0.5 [95% CI 0.4-0.8]). CONCLUSIONS: As the pandemic continues and older adults resume community mobility after a shelter-in-place period, providers should pay attention to the risk of falls.

External validation of the Johns Hopkins Fall Risk Assessment Tool in older Dutch hospitalized patients.

PURPOSE: Fall prevention is a safety goal in many hospitals. The performance of the Johns Hopkins Fall Risk Assessment Tool (JHFRAT) in older inpatients is largely unknown. We aimed to assess the JHFRAT performance in a large sample of Dutch older inpatients, including its trend over time. METHODS: We used an Electronic Health Records (EHR) dataset with hospitalized patients (≥ 70), admitted for ≥ 24 h between 2016 and 2021. Inpatient falls were extracted from structured and free-text data. We assessed the association between JHFRAT and falls using logistic regression. For test accuracy, we calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Discrimination was measured by the AUC. For calibration, we plotted the predicted fall probability with the actual probability of falls. For time-related effects, we calculated the AUC per 6 months (using data of patients admitted during the 6 months' time interval) and plotted these different AUC values over time. Furthermore, we compared the model (JHFRAT and falls) with and without adjusting for seasonal influenza, COVID-19, spring, summer, fall or winter periods. RESULTS: Data included 17,263 admissions with at least 1 JHFRAT measurement, a median age of 76 and a percentage female of 47%. The in-hospital fall prevalence was 2.5%. JHFRAT [OR = 1.11 (1.03-1.20)] and its subcategories were significantly associated with falls. For medium/high risk of falls (JHFRAT > 5), sensitivity was 73%, specificity 51%, PPV 4% and NPV 99%. The overall AUC was 0.67, varying over time between 0.62 and 0.71 (for 6 months' time intervals). Seasonal influenza did affect the association between JHFRAT and falls. COVID-19, spring, summer, fall or winter did not affect the association. CONCLUSIONS: Our results show an association between JHFRAT and falls, a low discrimination by JHFRAT for older inpatients and over-prediction in the calibration. Improvements in the fall-risk assessment are warranted to improve efficiency.

Association between Prevention from Going Out and Incidence of Falls among Community-Dwelling Older Adults during COVID-19 Pandemic.

To prevent falls, community-dwelling older adults must maintain regular physical activities. This study aimed to explore the association between the prevention from going out and the incidence of falls among community-dwelling older adults during the COVID-19 pandemic. We conducted a prospective cohort study that consisted of 381 individuals aged 65 years or older, living in a local community in Japan, and ranging from being independent to being physically and cognitively frail. The finding revealed that among those who had been going out five or more times weekly pre-pandemic, the prevention from going out at the time of the first state of emergency (SOE) (AOR = 6.84; 95%CI = 1.51-31.02), having history of falls (AOR = 7.35; 95%CI = 1.81-29.84), participating in group gatherings (AOR = 6.09; 95%CI = 1.48-25.12), living with spouses (AOR = 0.08; 95%CI = 0.02-0.40), and living with other than spouse (AOR = 0.15; 95%CI = 0.03-0.73) were associated with the incidence of falls. The study highlights the importance of providing regular opportunities to go out to community-dwelling older adults in order to prevent falls.

A mental health-informed, online health promotion programme targeting physical activity and healthy eating for adults aged 60+ years: study protocol for the MovingTogether randomised controlled trial.

BACKGROUND: The COVID-19 pandemic and associated social distancing regulations have led to an increased risk of social isolation and physical inactivity, particularly among older adults. The benefits of physical activity for reducing fall risk and improving mood and mental functioning have been well documented. The aim of this trial is to investigate the effect of the MovingTogether programme on psychological distress (primary outcome) and physical activity, social capital, cognition, concern about falling, loneliness, physical functioning, quality of life and physical activity enjoyment (secondary outcomes). METHODS: A randomised controlled trial with a waitlist control will be conducted, recruiting 80 adults aged 60+ years with access to Facebook and a computer or tablet and not currently meeting the aerobic physical activity guidelines. Randomisation will be completed using REDCap. The intervention group (n = 40) will join a private Facebook group where allied health facilitators will provide targeted healthy lifestyle education throughout the 10-week programme with weekly telehealth group calls. Intervention participants will also be provided access to tailored strength and aerobic exercise guidance and an evidence-based eHealth balance exercise programme. Psychological distress and secondary outcomes will be assessed at baseline, 11 weeks (post-intervention) and 16 weeks (1-month follow-up). Linear mixed models will be applied for each outcome measure as per an intention-to-treat approach to determine the between-group differences. Secondary analyses are planned in people with greater adherence and those with higher psychological distress. DISCUSSION: COVID-19 has highlighted the need for scalable, effective and novel methods to improve and protect the health of older adults. The integration of an evidence-based fall prevention programme with a mental health-informed online health promotion programme may help to improve mental and physical health outcomes among older adults. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12621001322820p. Registered on 29 September 2021.

Effects of a psychomotor program developed in the COVID pandemic on risk factors for falls in nursing home older adults

Objective: This study aimed to determine the effects of a psychomotor program performed during the COVID pandemic on risk factors for falls in nursing home older adults. Method(s): The study involved 10 nursing home older adults (aged 67-91 years old) who integrated two periods without intervention (control: pre-lockdown;and lockdown) and an experimental period (attending the program). Cognitive, emotional and physical functioning risk factors for falling were measured before and after each period. Result(s): Friedman's Test followed by Pairwise Comparison post-test showed that the program induced significant improvements with an effect size (EF) ranging from large to small in the follow risk factors: fear of falling (EF=3.22), depressive states (EF=1.49), static balance (EF=0.83), lower strength (EF=0.76), upper strength (EF=0.73), cognitive status (EF=0.58), upper flexibility (0.52), perception of affordances - real (EF=0.51) and estimated (EF=0.45), agility and balance (EF=0.37), balance and mobility (EF=0.36), lower flexibility (EF=0.24) and aerobic resistance (EF=0.21), (p<0.05). On the other hand, in the no-intervention periods, lower and upper strength, upper flexibility and perception of affordances - estimated significantly decreased (p<0.05). Conclusion(s): Results from the study showed that the psychomotor program was effective in falls prevention by improving cognitive, emotional and physical functioning risk factors for falling. These findings suggest that for older adults' good quality of life, psychomotor programs should be implemented in nursing homes.

Individual telerehabilitation program for improving balance in people with MS

Introduction: During the Covid-19 pandemic, the provision of rehabilitation care to people with MS was significantly reduced (in addition, many patients were afraid to visit medical and sports facilities). An alternative (in these cases) could be telerehabilitation (ie the provision of rehabilitation services at a distance). The aim of our pilot study was to evaluate the feasibility of this form of rehabilitation in people with MS with balance disorders. Method(s): Our pilot study included 20 patients with MS with balance disorders. The intervention lasted 12 weeks. The experimental group underwent individual telerehabilitation (twice a week, 45 individual telerehabilitation), which consisted of balance and strength exercises with a physiotherapist, using the Homebalance system and other simple tools). The control group received regular rehabilitation care (outpatient individual physiotherapy). Functional tests were selected to assess the gait and balance disorders: Timed Up and Go (TUG), TUG with dual cognitive task and Berg Balance Scale (BBS). Subjective perceptions of gait, balance and fatigue disorders were evaluated with standardized questionnaires: Modified Fatigue Impact Scale (MFIS), Multiple Sclerosis Walking Scale-12 (MSWS-12), Falls Efficacy Scale International (FES-I), Activity Balance Confidence Scale (ABC Scale ). Result(s): The mean age of participants was 51 years (34-65 years), with the mean disease duration was 17 years (4-29 years) with a median neurological disability EDSS 5 (3-6.5). There was a significant improvement in the experimental group in the functional mobility test-TUG (p=0.048), balance-BBS (p=0.002) and in the standardized ABC Scale questionnaire (p=0.041). Conclusion(s): The results of the pilot study suggest that individual telerehabilitation could be an alternative to routine rehabilitation care for the treatment of balance and mobility disorders in patients with MS (suitable, for example, for people with a more distant place of residence or in case of new pandemic restrictions).