A pilot study exploring the effectiveness of the Lifestyle approach to reducing Falls through Exercise (LiFE) in the stroke population.

INTERVENTION: Participants will be taught the principles of balance and strength training and actively participate in devising activities that will be implemented in a planned and incremental manner over 12 weeks. Eight balance (including static and dynamic) and six strength (hip, knee and ankle) domains will form the basis of these activities that will be embedded within the individual’s daily activities and weekly routines. Home visits, conducted by occupational therapists and physiotherapists, will take place once per week in weeks 1‐6 and in week 8; length of home visits will be 90 minutes on average. A telephone call will occur in weeks 7 and 9; length of telephone call will be 15 minutes on average. LIFE participants will also use a tally counter to assist with counting activity frequency for their adherence logs. Participants in this group will be given: (i) Support in the adoption of exercises. Social cognitive learning strategies will be utilised based on concepts of enhancing self‐efficacy. This includes mastery experiences, teaching simple incremental steps, positive verbal persuasion and self‐monitoring (exercise logs). (ii) Assistance in maintenance over the longer term and protection against relapse. Adequate follow up and support helps individuals reflect on barriers and problem solve, and (iii) consideration to safety in performance and incremental progression of exercises. It is important to note that patients after stroke do not currently receive any of these interventions or supports as part of their ongoing community‐based rehabilitation or care. CONDITION: Falls Stroke PRIMARY OUTCOME: Fall surveillance. The primary outcome in this study is the occurrence of falls. Participants will record on each day if they fall or not on a weekly self‐report falls surveillance calendar. SECONDARY OUTCOME: A self‐report functional status questionnaire of 8 domains (ADL and IADL) from NHANES 1 Epidemiological Follow‐up Study (1986) Adherence. Participants will track adherence by completing daily exercise logs reporting the domain, level and frequency of the exercises done each week. Balance. Static balance will be measured using hierarchical series of stands with diminishing base of support and vision and dynamic balance by the timed Get up and Go. Habitual physical activity and sedentary behviour evaluation scale which includes items asking questions about the type of physical participation in sedentary, household, work, leisure and sporting activities over the past seven days. Self efficacy. The Tinetti Falls‐Efficacy Scale (FES) will assess situation specific and confidence in avoiding falls when performing basic activities of daily living. INCLUSION CRITERIA: Community living men and women aged 70 or older who have been admitted to an Alfred Health department or service after stroke, and who recall they have had two or more falls/slips or have had one injurious fall in the past 12 months.