None listed
Conditions
Brief summary
Falling is one of the most frequent complications seen in stroke patients early after they are discharged home. Thus, finding ways to prevent falls, especially among individuals prone to repeated falls, is urgent. This study will explore whether this integrated lifestyle approach (LiFE) in reducing falls is able to be used with the stroke population, and if so, whether participants experience similar improvements. The LiFE approach involves embedding balance and strength training within habitual daily routines, and has been shown to be effective for reducing falls in older people without stroke. What is unknown to date is whether this functional based exercise approach is also effective in the specific stroke population. This study is a pilot study which will test the feasibility of using the LiFE approach to balance and strength training with a group of stroke patients living in Melbourne. The protocol will randomly assign ten (10) participants to one of two groups: the LiFE falls prevention program or a usual care control group. The usual care control group will receive the Alfred Health Occupational Therapy Falls handout, plus 7 strengthening exercises and encouragement to complete these 3 times per week. The LiFE group will receive the balance and strengthening program once per week in their own home. The study period is 10 weeks. The aim of the study is to determine acceptability of the LiFE approach, as well as to begin to understand its efficacy in the stroke population. Data will be collected at baseline, at 3 months and at 6 months. Findings will not only provide important information on falls prevention rehabilitation for Alfred Health, but will also provide data useful for planning a larger clinical trial.
Interventions
Participants will be taught the principles of balance and strength training and actively participate in devising activities that will be implemented in a planned and incremental manner over 12 weeks. Eight balance (including static and dynamic) and six strength (hip, knee and ankle) domains will form the basis of these activities that will be embedded within the individual’s daily activities and weekly routines.
Home visits, conducted by occupational therapists and physiotherapists, will take p
Participants will be taught the principles of balance and strength training and actively participate in devising activities that will be implemented in a planned and incremental manner over 12 weeks. Eight balance (including static and dynamic) and six strength (hip, knee and ankle) domains will form the basis of these activities that will be embedded within the individual’s daily activities and weekly routines. Home visits, conducted by occupational therapists and physiotherapists, will take place once per week in weeks 1-6 and in week 8; length of home visits will be 90 minutes on average. A telephone call will occur in weeks 7 and 9; length of telephone call will be 15 minutes on average. LIFE participants will also use a tally counter to assist with counting activity frequency for their adherence logs. Participants in this group will be given: (i) Support in the adoption of exercises. Social cognitive learning strategies will be utilised based on concepts of enhancing self-efficacy. This includes mastery experiences, teaching simple incremental steps, positive verbal persuasion and self-monitoring (exercise logs). (ii) Assistance in maintenance over the longer term and protection against relapse. Adequate follow up and support helps individuals reflect on barriers and problem solve, and (iii) consideration to safety in performance and incremental progression of exercises. It is important to note that patients after stroke do not currently receive any of these interventions or supports as part of their ongoing community-based rehabilitation or care.
Sponsors
Associate Professor Natasha Lannin
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used) (Outcomes Assessor)
Eligibility
Sex/Gender
All
Age
70 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Community living men and women aged 70 or older who have been admitted to an Alfred Health department or service after stroke, and who recall they have had two or more falls/slips or have had one injurious fall in the past 12 months.
Exclusion criteria
Exclusion criteria are moderate-severe cognitive problems (as indicated by a score of 18 or less on the Mini Mental State examination or moderate-severe impairment in any category on the Cognistat), no conversational English, inability to ambulate independently, resident in a nursing home or hostel, or any unstable or terminal medical illness which would preclude the planned exercises and is unlikely to resolve (e.g. aortic aneurysm, malignant arrhythmias, critical aortic stenosis, rotator cuff tear & active hernias).
Outcome results
None listed