32 The sum score ranges between 0 (no confidence) and 100 (completely confident). The MS Impact Scale was filled in at study start to describe the disease impact on daily functioning.51 It is

a 29-item self-report measure, with 20 items associated with a physical scale and 9 items with a psychological scale. Each item is scored on a scale ranging from 1 (not at all) to 5 (extremely). A score (0–100) is calculated for each subscale (sum score − 20)/80 × 100 and (sum score − 9)/36 × 100). High scores indicate greater impact. Descriptive statistics were calculated for demographic data. The McNemar test was used to assess differences in proportions of fallers, and the Wilcoxon signed-rank Bortezomib mouse test was used for differences in number of falls for the respective periods. The Friedman test was used to assess differences between test occasions where the data were ordinal or deviated from a normal distribution (Shapiro-Wilk test), or both. Where significant differences were detected, the Wilcoxon signed-rank test was used to detect where the differences occurred. A Bonferroni adjustment was then calculated using the significance level (.05) divided by the number of tests run (15), which equals .0033. If the P values were larger than .0033, the results were considered not statistically significant. For normally distributed data, 1-way

buy Sirolimus repeated-measures analysis of variance with a Greenhouse-Geisser correction was used

to calculate overall differences between related means, with Bonferroni correction for multiple comparisons. Version 17.0 of the SPSS software package a was used for the statistical analyses. Thirty-two participants (26 women) with a mean age±SD of 56±11.3 years completed the intervention and had complete fall diaries, and 29 of them also attended all test occasions (see fig 1). Eleven participants had relapsing-remitting MS; 16, secondary progressive MS; and 5, primary progressive MS. The mean duration±SD since MS diagnosis was 15.6±12.2 years. Six participants used a walking aid indoors and 21, outdoors. The physiological impact of MS was mild (MS Impact Scale [mean±SD], 45.3±18.5; range, 7.5–75), as was the psychological impact (MS Impact Scale [mean±SD], 37.1±22.9; range, 0–88.9).52 The median intervention attendance rate was 12 of 14 sessions 4��8C (25%–75% interquartile range, 9.2–13). Five persons never attended the exercise group, and 2 persons attended only once; all 7 were excluded. Reasons for dropout were lack of time (n=4) and illness (n=3). Before the intervention, 53% of those with complete falls data were classified as fallers, and 44% of the total sample were classified as multiple fallers (78% of the fallers). A reduction of falls was reported between the preintervention period (A) and both periods B and C (table 1). The number of falls reported during period C was 123 less than that during period A.