SERVICE EVALUATION OF LIFESTYLE INTEGRATED FUNCTIONAL EXERCISE PROGRAM FOR FALLS PREVENTION IN EARLY SUPPORTED DISCHARGE STROKE PATIENTS

Purpose

Stroke survivors are at greater risk of falling both as inpatients and through their post stroke life (Weerddesteyn et al 2008). It is suggested that research is needed to specify effective behavioural approaches to increase exercise post stroke (Prior and Suskin 2018). A falls programs that incorporates behaviour change is the Life style integrated functional exercise (LiFE) program for falls prevention (Clemson et al 2012).
The service evaluation was a 2 site study to evaluate the LiFE programme to prevent falls a behaviour change approach compared to conventional Physiotherapy in Early Supported Discharge (ESD) stoke patients in a community setting.

Approach

A shortened six week version of the LiFE program was carried out on seven ESD patients and six ESD patients received conventional Physiotherapy only. Tinetti outcome measures and Timed up and go (TUG) were measured at the start of the intervention and on discharge. Patients receiving the LiFE program were asked if they would continue with the LiFE program on discharge from the service.

Outcomes

Results: All patients on the LiFE program improved Tinetti and TUG, all patients receiving conventional physiotherapy improved in Tinetti only.
On discharge 57% of participants declined to continue the LiFE program and 42% reported they were too fatigued to engage fully with the program.

Conclusion(s): Fatigue was a significant limiting factor in participation of the LiFE program. Patients receiving the LiFE falls prevention program and conventional physiotherapy improved in mobility and balance. There was a relatively low number continuing with the
LiFE program. This may indicate that a shortened version of 6 weeks therapy intervention may not be long enough to fully engage service users. Further investigation is required to assess the effectiveness of the full LiFE program for falls prevention in a stroke population.

Cost and savings

No further information is available.

Implications

The Service Evaluation highlights the use of a behaviour change approach by Allied Health Professionals to facilitate stroke survivors to integrate exercise into daily life. With an increasing demand on resources, interventions that encourage individuals to self manage to promote physical activity should be investigated. NICE’s recent guidance on behaviour change (NICE 2007) recommends the use of appropriate interventions to support attitude and behaviour change at population and community levels (NICE 2007).

Top three learning points

Not available. 

Funding acknowledgements

Purchase of the LiFE trainers and participants manuals was funded through the Winston Churchill Memorial Trust Fellowship follow up funding.