Data-driven Intervention to Reduce Pre-discharge Fall Risk After Stroke
MGH Institute of Health Professions
Summary
After stroke, falling is a common problem. Falls can lead to injury, as well as fear of future falls. It is important to try to prevent falls from happening after stroke. To goal of this study is to test a new treatment to try to prevent falls after stroke. The people in the study will be patients who are in the hospital receiving care after a stroke. While they are in the hospital, the investigators will provide extra treatment that focuses on helping them not to fall. The investigators will also teach the patients to understand risks for falls and how to avoid them. When they leave the hospital, participants will be sent a text message every day to ask if they have had any falls. The goal is to see if patients who received the extra therapy have fewer falls than patients who did not receive the therapy and education to help avoid falls. If the extra treatment in the hospital can help stop people from falling after they leave the hospital, this will have a positive impact on their lives. By not falling, they will avoid the risk of injury and having to go back to the hospital. This project will help the investigators know how to help people with stroke live longer, healthier lives.
Description
Falls are one of the most significant problems for stroke survivors, often resulting in injury, fracture, rehospitalization, recurrent falls, fear of falling, avoidance of physical activity, and subsequent restricted social participation. The rate of falls among stroke survivors is exceptionally high, especially in the first 1-3 months after discharge home from the hospital. The high rate of early post-stroke falls occurs despite intensive inpatient rehabilitation and ongoing rehabilitation after hospital discharge. The central hypothesis to be tested in this study is that a personalized fall…
Eligibility
- Age range
- 45–85 years
- Sex
- All
- Healthy volunteers
- No
Inclusion Criteria: * Inpatient rehabilitation admission for diagnosis of stroke * Test positive for fall risk at admission (step-test and obstacle-test, "STOB", \>/= 3 out of 8) * No pre-stroke history of falls * Community dwelling and independent in basic and instrumental activities of daily living prior to stroke * Able to follow 1-step verbal command and demonstrate comprehension and decision-making capacity to consent to study participation * Able to stand upright for 10 seconds with assistance of no more than one person Exclusion Criteria: * Brain hemorrhage due to trauma * Prior stro…
Interventions
- BehavioralFall Prevention Intervention
The fall prevention rehabilitation program will be provided by a licensed physical therapist and will target modifiable fall risk factors known to be associated with future fall risk after inpatient rehabilitation for stroke. The intervention will be personalized to the individual's fall risk profile at admission. Participants will be educated about physical, cognitive/attentional, and environmental factors associated with falls.
- BehavioralActive Control
The control intervention will not include any of the key ingredients in the experimental intervention. The activities will not target known modifiable factors for fall risk, but the treatment will be a skilled therapy by a licensed provider, matching the dose of the experimental intervention. Participants in the control group will receive education about stroke, stroke recovery, stroke prevention, wellness, and community support groups.
Location
- Spaulding Rehabilitation HospitalBoston, Massachusetts