Falls after stroke

Many people who have had a stroke experience falls; approximately twice as many as the general older population. But we can do something to combat this!

Between 2019-2023, I had the privilege of delivering interventions on the Falls After Stroke Trial, which was published in the BMJ this week.

Participants received 10 therapy visits (7 weekly visits and some follow-ups) plus 2 phone calls over a 6-month intervention period. Intervention aims were 3-fold; 1. Improve home safety by addressing environmental and behavioural risk factors. 2. Establish habits of effective strength and balance training into daily life and 3. Coaching and training in safe community mobility, based around goals set by the participant.

With a one-third reduction in falls in the intervention group compared to the control group, this was the first-ever clinical trial to demonstrate a significant impact on falls risk utilising non-pharmaceutical intervention.

I think that a large part of the success of this trial was in the extent of progressive practice that participants achieved by incorporating challenging activities safely into daily life. People were taught and coached not only in 'which exercises' to do, but how to maximise daily practice and how to progress. In combination with simple but effective risk-reduction strategies, stroke survivors were empowered to gradually take on more challenging activities, more safely. This, to me, is the essence of good therapy.

Congratulations to the research team on excellent intervention design!