Learning Independent Floor Transfers (LIFT): A pilot feasibility study of a floor transfer training program embedded within a home-based community rehabilitation program for adults at risk of falls

The LIFT study aims to design and evaluate the feasibility of a 6-week floor transfer training program, called the LIFT program, in adults recently discharged from hospital who are at risk of falls. During phase 1 (duration 3 months), the LIFT program will be co-designed by people with experience of falls or difficulty getting up off the floor and physiotherapists working in a home-based community rehabilitation program within a large public metropolitan health service in Melbourne, Australia. This process will involve semi-structured interviews with two consumers (duration 1 hour) and two focus groups with eight physiotherapists (duration 1.5 hours) to identify their experiences with floor transfer training, barriers and enablers to practising floor transfers and key design requirements of the LIFT program to support effective implementation of an evidence-based floor transfer training program in a home-based setting. Former patients of the program who undertook some sort of floor transfer practice and all physiotherapists working at least 2 days/week in the Home-Based Community Rehabilitation program will be invited to participate in the interviews which will be conducted by a member of the research team. The LIFT program will then be developed and follow-up interviews with the same consumers (duration 1 hour) and focus-groups with physiotherapists (duration 1.5 hours) will be conducted to gather feedback on program components and refine the program's design. During phase 2 (duration 6 months), the feasibility and acceptability of the LIFT program will be evaluated with 10 participants and their treating physiotherapists. All physiotherapists working within the Home-Based Community Rehabilitation team will receive 2 hours of face-to-face training from members of the research team on how to deliver the LIFT program. Following this training, physiotherapists will then start screening patients within the Home-Based Community Rehabilitation program on initial assessment for potential inclusion in the study. For patients included in the LIFT study, the LIFT program will be delivered in a person's home and embedded within weekly 60-minute usual-care physiotherapy home visits. The program will be personalised for each participant following clinical assessment. The first session will involve assessment of the participant’s ability to get on and off the floor and training in an appropriate floor transfer technique. The floor transfer technique, or components of the technique, will then be practised each week over the five subsequent sessions, for 20 - 30 minutes each session. The remaining session time will be used to address any other goals identified by the participant. Once participants have mastered the floor transfer technique, it will be practised five times each session to maintain proficiency and incorporated into a regular home exercise program. Training will be performed using a sturdy chair or couch, gym mat and foam cushions as needed. Physiotherapists will also have access to a Raizer II lifting chair, which is a portable battery powered device that can be easily used by a single operator to assist a person up off the floor. The lifting chair will provide safety support to the participant and physiotherapist and be used if the participant is struggling to get up off the floor. Physiotherapists will document the content and duration of each session using a pre-specified treatment record to monitor adherence to the key features of the LIFT program.