Evaluating a Novel Multifactorial Falls Prevention Activity Programme for Community-Dwelling Older People After Stroke: A Mixed-Method Feasibility Study

Abstract

Jun Sheng Gary Koh,1 Anne-Marie Hill,1 Keith D Hill,1,2 Christopher Etherton-Beer,3 Jacqueline Francis-Coad,1 Elizabeth Bell,1 Liz Bainbridge,1 Lex D de Jong1 1School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Bentley, Perth, WA 6102, Australia; 2Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Melbourne, Victoria, Australia; 3WA Centre for Health and Ageing, Royal Perth Hospital Unit, School of Medicine and Pharmacology and Centre for Medical Research, University of Western Australia, Perth, Western Australia, AustraliaCorrespondence: Lex D de JongSchool of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Bentley, Perth, WA 6102, AustraliaEmail [email protected]: The overall purpose of this study was to explore participants’ and physiotherapists’ experiences regarding the acceptability, implementation, and practicality of a novel group-based multifactorial falls prevention activity programme for community-dwelling older people after stroke. Specifically, the purpose was to explore if and how participating could impact on the participants’ health-related quality of life (HRQoL) in terms of their daily lived experience regarding physical, mental, emotional and social well-being. A secondary purpose was to explore whether participating in the programme could positively influence participants’ balance, strength, falls efficacy, mobility and motor impairment of the trunk.Materials and Methods: This was an exploratory mixed-method Phase I feasibility study. A convenience sample of five older community-dwelling people after stroke participated in a novel eight-week multifactorial activity programme which included falls education, a mix of individually tailored and group-based strength and balance exercises, exploring limits of stability and safe landing techniques and a social element. Qualitative data from post-intervention interview transcripts with the participants and the physiotherapists who delivered the programme were thematically analysed using both deductive and inductive approaches to explore the participants’ and therapists’ experiences with the programme. Quantitative outcomes included balance, strength, falls efficacy, mobility and motor impairment of the trunk.Results: The programme was deemed feasible in terms of acceptability, implementation and practicality by the participants as well as the physiotherapists delivering the programme. The overarching theme regarding HRQoL identified that participating in the programme was perceived to empower the participants living with stroke and positively influenced their daily physical, mental, emotional and social well-being. Participant outcomes showed a change in the direction of improvements in balance, strength, mobility, motor impairment of the trunk and reduced concerns about falling. Subjectively, participants only reported perceived improvements in balance and strength.Conclusion: Running a novel multifactorial falls prevention activity programme for older community-dwelling people after stroke was feasible. Participating in the programme helped participants to perceive improved balance, strength and empower them to make meaningful changes, improving their daily lived experiences. A future fully powered study could build on these results to investigate physical improvements, prevention of falls and improvements to domains of HRQoOL.Keywords: accidental falls, aged, exercise, evaluation studies as topic, stroke, qualitative research, quality of life

Keywords

• accidental falls
• aged
• exercise
• evaluation studies as topic
• stroke
• qualitative research
• quality of life.