Dr. Susan Coote:

That is a very important point. We know that people with multiple sclerosis, stroke and Parkinson's fall at the same rate as people who are over 85, so falls are a significant issue for this population. However, the key thing is that the falls treatments that we would do with somebody over 85 are completely different from those for somebody with MS who is 36 and raising a family because they have completely different falls risk factors than the over 85s. That again highlights the specialist nature of it. If we look at the research evidence for preventing falls in this population, there are very different structures and treatments that we would have as therapists working together to address this than, for example, in regard to falls prevention for older people. While there have been huge advances in terms of therapy posts for enhancing community care for older persons, that is not applicable to this cohort. They have very different needs and need a very different specialism from therapists who understand the falls risk factors that are unique to them, like issues of spasticity, stiffness or the interface between memory, thinking and planning and falls risk.

It is a very specialist subspecialty in itself and it is one for which there is significant research evidence. We know from our own work that we can reduce the number of falls people have by 50% by providing intervention in the community both from these community neurorehabilitation teams and also from the work of the charities which then supplement this work in terms of implementing programmes to maintain their status after rehabilitation.