Imagine recovering from a stroke and then facing the fear of falling at home. For many stroke survivors, this fear is all too real, as falls can lead to serious injuries and setbacks. A recent study explored a home-based program designed to help these individuals by improving their strength, balance, and confidence. Over six months, participants received personalized exercises and coaching to make their homes safer and enhance their ability to move around their communities. The results were promising: those in the program experienced about one-third fewer falls compared to those who received standard care. Beyond just preventing falls, participants reported feeling more confident and engaged in their daily activities. However, it’s important to note that not everyone in the program avoided falls entirely, and more research is needed to refine these interventions. Still, this approach offers hope for stroke survivors, showing that with the right support, they can reclaim their independence and live with less fear of falling.
Could a Simple Home Program Cut Falls for Stroke Survivors?
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What this means for you:
A tailored home program can significantly reduce falls for stroke survivors, boosting their confidence and independence. What this means for you:
A tailored home program can significantly reduce falls for stroke survivors, boosting their confidence and independence. View Original Abstract ↓
OBJECTIVE: To investigate the effectiveness of a multidisciplinary, home based, tailored intervention to reduce falls after stroke.
DESIGN: Two armed, randomised trial.
SETTING: Three states in Australia.
PARTICIPANTS: People within 5 years of stroke, aged >50 years, discharged from formal rehabilitation to the community, and able to walk 10 m across flat ground with or without an aid. Those with moderate-to-severe receptive aphasia or walking speed >1.4 m/s without falls in the previous year were excluded.
INTERVENTION: Over 6 months, the experimental group received a habit forming functional exercise, home fall hazard reduction, and goal directed community mobility coaching; the control group received usual care. Physiotherapist and occupational therapist dyadic teams worked collaboratively to deliver the intervention.
MAIN OUTCOME MEASURES: The primary outcome was rate of falls over 12 months. Secondary outcomes were proportion of participants having a fall, community participation, self-efficacy, balance, mobility, physical activity, activities of daily living, depression, and health related quality of life.
RESULTS: Between August 2019 and December 2023, 370 people with stroke were enrolled. At 12 months, a significant between group difference was seen in the rate of falls in favour of the experimental group, representing a 33% reduction in falls (incidence rate ratio 0.67, 95% confidence interval (CI) 0.48 to 0.94; P=0.02). No significant between group difference was seen in the number of participants having a fall (absolute risk reduction 0.03, 95% CI -0.07 to 0.13; P=0.52). The main between group differences in favour of the experimental group were in community participation (Late Life Function and Disability Instrument disability limitation: mean difference 3% (95% CI 1% to 6%); P=0.02), self-efficacy (mean difference 0.6 (0.2 to 1.0); P=0.004), mobility (fast walking speed: mean difference 0.13 (0.06 to 0.19) m/s (P<0.001); preferred walking speed: 0.06 (0.02 to 0.10) m/s (P=0.02)), and balance (Step Test: mean difference 0.06 (0.01 to 0.12) steps/s; P=0.03).
CONCLUSION: A tailored intervention prevented falls in community dwelling, ambulatory people with stroke. The decrease in the rate of falls was underpinned by clinically worthwhile improvements in self-efficacy, mobility, community participation, and balance.
TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12619001114134.