Home-Based Stroke Therapy Cuts Falls by Third in Major Trial

A groundbreaking Australian trial involving 370 stroke survivors has demonstrated that home-based intervention programmes can reduce falls by a third – offering hope for thousands of patients across Kent who face heightened risks after leaving hospital.

The figures show stroke survivors experience a 1.5-fold increase in fall risk compared with the general population. But this randomised controlled trial, published in the BMJ, found those receiving tailored home-based care achieved an incidence rate ratio of 0.67, representing a statistically significant 33% reduction in falls over 12 months.

What Made the Difference

The intervention combined three key elements delivered by physiotherapist and occupational therapist teams over six months. Participants received habit-forming functional exercise routines, home fall hazard reduction assessments, and goal-directed community mobility coaching.

Data from the trial, which enrolled patients between August 2019 and December 2023, showed the control group averaged 2.7 falls per participant. The intervention group recorded substantially fewer incidents across the same period.

But the benefits extended beyond fall prevention. Secondary outcomes revealed clinically worthwhile improvements in self-efficacy, with a mean difference of 0.6 points favouring the intervention group. Community participation, balance, and walking speed all showed measurable gains.

Breaking New Ground

Previous evidence on fall prevention interventions specifically for stroke survivors had been limited. Earlier studies hadn’t demonstrated effectiveness in reducing actual fall rates – making these results above all significant for rehabilitation services.

The trial focused on people within five years of stroke, aged over 50, who had been discharged from formal rehabilitation to community settings. All participants could walk 10 metres across flat ground with or without walking aids.

Home-based exercise programmes have shown promise in broader populations. Meta-analysis of four randomised trials in primary prevention settings demonstrated similar reduction rates among older adults generally.

Yet this represents the first solid evidence that targeted interventions can meaningfully reduce falls among stroke survivors – a group facing particular challenges with mobility, balance, and confidence.

Key Takeaways

• Home-based physiotherapy and occupational therapy reduces stroke survivor falls by 33%
• Intervention improves balance, walking speed, confidence and community participation
• Previous fall prevention programmes for stroke patients hadn’t proven effective until now

What This Means for Kent Residents

Stroke survivors across Kent and Medway could benefit if local NHS services adopt this evidence-based approach to rehabilitation. The findings are directly relevant to NHS Kent and Medway ICB stroke services and community physiotherapy teams currently supporting patients after hospital discharge. Residents or family members concerned about fall risks following stroke should discuss these intervention options with their GP or stroke rehabilitation team, as the coordinated approach requires trained physiotherapist and occupational therapist partnerships that may need commissioning through local integrated health and social care services.