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Home-based, tailored intervention for reducing falls after stroke (FAST): Protocol for a randomized trial.

Catherine Dean¹, Lindy Clemson², Louise Ada²

¹Faculty of Medicine, Health and Human Sciences, 7788Macquarie University, Sydney, Australia.

International Journal of Stroke : Official Journal of the International Stroke Society

|February 11, 2021

Summary

This study investigates a home-based intervention to reduce falls in stroke survivors. The Falls after Stroke Trial (FAST) aims to improve safety and quality of life for this vulnerable population.

Keywords:

Behaviour change community participation falls prevention home safety randomized trial stroke

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Area of Science:

Gerontology
Neurology
Rehabilitation Medicine

Background:

Stroke survivors experience falls at more than double the rate of the general older population, leading to significant injuries.
Current interventions are insufficient in preventing post-stroke falls, highlighting a critical gap in care.
Falls after stroke (FAST) trial addresses the urgent need for effective fall prevention strategies in community-dwelling stroke survivors.

Purpose of the Study:

To evaluate the effectiveness and cost-benefit of a novel, home-based, tailored intervention designed to decrease fall rates in individuals post-stroke.
To assess the impact of the intervention on secondary outcomes including fall risk, community participation, self-efficacy, balance, mobility, physical activity, depression, and quality of life.

Main Methods:

A multistate, Phase III randomized controlled trial (FAST) involving 370 ambulatory stroke survivors within five years of stroke.
Participants, discharged to the community with no significant language impairment, were randomized to receive either a tailored intervention (exercise, home safety, community mobility) or usual care.
The trial employed concealed allocation, blinded assessment, and intention-to-treat analysis to ensure robust methodology.

Main Results:

The primary outcome is the rate of falls over a 12-month period.
Secondary outcomes include the proportion of fallers, community participation, self-efficacy, balance, mobility, physical activity, depression, and health-related quality of life.
Healthcare utilization data were collected at baseline, 6 months, and 12 months.

Conclusions:

The findings from the FAST trial are expected to provide crucial evidence for developing effective interventions for stroke survivors living in the community.
This research aims to directly influence clinical practice and improve the long-term well-being and safety of individuals recovering from stroke.