None listed
Conditions
Brief summary
This study is focused on preventing falls in people with stroke. Falls are common, particularly in the early stages following stroke and following the transition from hospital to home, with around half of people falling in the first 6 months after stroke. These falls can have serious consequences such as bone fracture, head injury, or death. There are a number of factors which can increase a person’s risk of falls, including poor balance, environmental hazards, sensory deficits, and medications. Evidence suggests effective falls prevention programs should include a tailored approach addressing individual risk factors, and include balance-specific exercises. This study will pilot an individualised, multifactorial telehealth-supported falls prevention program for people with stroke who are being discharged from hospital to home. The study will test the feasibility and potential benefit of this program in 16 individuals with stroke who are at risks of falls following discharge home from an inpatient setting. Participants will be recruited prior to discharge home and will undertake a 4-week program in addition to their usual care. The program will include a comprehensive falls risk assessment and tailored intervention based on identified risks and agreed goals, and using health behaviour change techniques (exploration of individual barriers and facilitators to recommended fall prevention behaviours). This will involve twice weekly physiotherapy sessions (in person or via videoconferencing or phone call) to review or supervise home exercises, review goals and discuss barriers and strategies for falls prevention. Environmental modifications and referral to other services will be undertaken as required. Participants will undergo in person home-based testing at baseline (within one week after discharge home) and at 4 weeks. Participants will also be interviewed within 3 weeks of completion, asking about their experience of the program. This project will inform the development of a randomised controlled trial and may help inform development of future falls prevention programs that can be delivered with greater efficiency.
Interventions
Brief name: A multifactorial telehealth-supported falls prevention intervention for people with stroke transitioning home.
Description: The intervention will involve a 4-week program provided in addition to usual care following discharge from an inpatient service. This will include a comprehensive assessment of falls risk (e.g., physical function, cognition, medications and home safety) and development of a tailored program using behaviour change techniques (e.g., shared goal setting and proble
Brief name: A multifactorial telehealth-supported falls prevention intervention for people with stroke transitioning home. Description: The intervention will involve a 4-week program provided in addition to usual care following discharge from an inpatient service. This will include a comprehensive assessment of falls risk (e.g., physical function, cognition, medications and home safety) and development of a tailored program using behaviour change techniques (e.g., shared goal setting and problem solving). The initial session will be conducted in the person's home within one week post discharge. With the exception of one in-person visit, all follow-up sessions will occur via telehealth (video or phone call), 30-45 minutes, twice weekly for four weeks. The intervention sessions will be undertaken by physiotherapists (>5 years experience), and will include falls prevention education, a tailored exercise program, discussion of goals and strategies, and engagement of other disciplines as required (e.g., environmental modifications and medication management). The research team will record the number and duration of all intervention and usual care sessions, and the participants will record the number and duration of falls prevention exercise sessions.
Sponsors
The Royal Melbourne Hospital
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adults who have been admitted to hospital due to stroke and deemed at risk of falls post discharge home from the inpatient setting (i.e., Berg Balance Scale < 49 or Step Test < 7 within one week prior to discharge or occurrence of fall during inpatient stay). Able to walk (with or without assistance; Functional Ambulation Category > 0). Availability of adequate support and access to technology to undertake telehealth sessions from home. Referred to follow-up therapy provided by the service (i.e., within the service catchment area).
Exclusion criteria
Inadequate understanding or capability to participate in informed consent or study procedures (e.g., due to language (i.e., requiring an interpreter or having moderate-severe receptive or severe expressive dysphasia), cognitive, vision or hearing issues). Any other medical conditions that would prohibit participation in a home exercise program (e.g., unstable angina).
Outcome results
None listed