Abstract TP319: Randomized Pilot Trial of Usual Care versus LIFE (Lifestyle Intervention using Functional Exercise to Reduce Falls) in Those with Mild Stroke

• Published in: Stroke (1970) 2013-02, Vol.44 (suppl_1)
• Main Authors: Korner-Bitensky, Nicol, Clemson, Lindy
• Format: Article
• Language: English
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/str.44.suppl_1.ATP319

Abstract only Purpose/Objectives: Falls are a health concern post-stroke with 30% of those who return home reporting loss of balance in the first month. Individuals with “mild” stroke are especially vulnerable as they are often discharged home quickly without exposure to balance improvement/falls prevention programs. It is important to identify effective interventions that can be offered in the naturalistic home setting. We assessed, for individuals with a first mild stroke, the impact of a home-based falls prevention program - LiFE (Lifestyle Intervention using Functional Exercise) vs STRUCTURED vs CONTROL intervention on rate of falls (self-report) and secondary outcomes including static and dynamic balance, etc.. This pilot RCT data is from a larger RCT (n=317) comparing these three interventions in older individuals (>70) at high risk for falls. Methods: Three group parallel RCT with all interventions taught at home. The LiFE group received teaching on principles of balance and strength training; applied while the individual performed common daily activities. STRUCTURED received balance and lower limb strength exercises while CONTROLS received gentle exercise. Blind assessments of the main outcomes of interest were performed before randomisation, after intervention (six months) and at one year (follow-up). Results: Of 39 participants 14 were randomized to LiFE; 14 to STRUCTURED; and, 11 to CONTROL. There were fewer fallers in the group receiving LiFE (n=6/14) vs the other two groups: (RR = 0.67; LiFE vs CONTROL); but not between STRUCTURED vs CONTROL (RR= 1.01). However, when number of falls was analyzed, LiFE had the greatest number - 26 vs 13 vs 20 - STRUCTURED and CONTROL respectively. Further data exploration revealed that LiFE was the only group with participants (n=3) who had >5 falls. Conclusion: Although LiFE was associated with a reduction in fallers; there was a disconcertingly higher rate of frequent falls in a few participants. These findings, while on a small sample, suggest that LiFE, which requires judgment and problem solving, may be suitable for a specified sub-set. The LiFE intervention “how to” and patient selection criteria will be discussed during the presentation.