Evaluating a Novel Multifactorial Falls Prevention Activity Programme for Community-Dwelling Older People After Stroke: A Mixed-Method Feasibility Study

Figures & data

Table 1 Participant and Physiotherapist Interview Topics

Introductory Question
● Can you start by telling me a little bit about your stroke and how has it affected your life since?
Questions about the feasibility of the programme (acceptability, implementation, practicality)
● How do you feel about the appropriateness of the activities/exercises/intensity of this programme?
● How do you feel about the suitability of this programme for (other) patients after stroke?
● How do you feel about the practical side of things during this programme?
● Have you ever had any safety concerns during the classes?
● Do you have any ideas about possible changes to the current programme that would help other patients after stroke to complete it in the future?
Questions about personal changes after the programme
● Have you noticed any physical/mental/emotional/social changes since participating in the programme?
● Have you noticed any changes in your independence/activities of daily living since participating in the programme?
● Do you have any further suggestions?

Table 2 Characteristics of the Five Participating People After Stroke

Characteristics	Participant 1	Participant 2	Participant 3	Participant 4	Participant 5
Age (years)	67	57	73	70	68
Gender	Male	Female	Male	Male	Male
Time since stroke (years + months)	1 + 6	2 + 4	9 + 1	9 + 11	3 + 5
Type of lesion	Haemorrhagic	Unknown	Haemorrhagic	Haemorrhagic	Ischemic
Hemiplegic side	Left	Right	Unclear	Right	Left
Mini Mental State Examination score	30	29	29	30	30
Self-rated health status	Very good	Good	Good	Good	Very good
Functional Ambulation Classification	4^a	6^b	6	6	6
Number of different types of medications taken per day	2	1	2	2	5
Previously discussed falls with your health provider?	Yes	Yes	Yes	Yes	Yes
Previously undertaken healthy ageing or falls prevention activities?	Yes	Yes	Yes	Yes	No
Number of falls, slips or trips in the past 12 months	3	0	1	0	2
Injurious falls in the past 12 months?	Yes	No	Yes	No	Yes
Number of falls, slips or trips during study period	5	0	0	^c	1

Notes: ^a4 = independent ambulator. ^b6 = ambulator, but dependent for supervision. ^cData missing.

Figure 1 The final conceptual framework relating to the health-related quality of life (HRQoL) domains.

Table 3 Participants’ Quantitative (Physical) Outcomes at Baseline and After Participating in the 8-Week Activity Programme

Outcome	Baseline	Outcome
BBS sum score, median (IQR)^a	49 (45 to 52.5)	53 (45 to 55.5)
EQ-5D-5L index value^b	0.72 (0.08)	0.81 (0.13)
FES-I sum score, median (IQR)^c	10 (7.5 to 12)	8 (7.5 to 12)
FTSTS, time (seconds)^d	13 (5.6)	10.4 (3.6)
FSST, time (seconds)^e	28 (19.6)	23.9 (18.4)
SIS domain scores, median (IQR)^f
Physical domain	83 (58.5 to 90.3)	91.8 (56.2 to 97.4)
Cognitive domain	89.3 (78.6 to 96.4)	96.4 (89.3 to 100)
Emotion domain	88.9 (82 to 95.8)	88.9 (76.4 to 97.2)
Communication domain	100 (98.2 to 100)	100 (92.9 to 100)
Participation domain	85.7 (58.9 to 96.4)	92.9 (41.1 to 96.4)
Visual Analogue Scale score (cm)	81 (8.9)	91.6 (8.5)
TIS, sum score, median (IQR)^g	15 (13 to 19)	18 (16 to 21)

Notes: ^aScores range from 0 to 56 where a higher score indicates better static and dynamic balance. ^bThe index value ranges between 0 and 1 where a score closer to 1 indicates a better health state. ^cScores range from 7 to 28 where a higher score indicates more concern over falling. ^dA shorter time indicates better functional mobility and strength. ^eA shorter time indicates better balance. ^fThe domain scores range from 0 to 100 and are calculated using the equation ((mean item score – 1)/4)*100. Higher item scores indicate a lower level of difficulty experienced with the task. The physical domain comprises the original SIS domains of strength, hand function, ADL/IADL and mobility. The latter are aggregated into a composite because they are highly correlated. The majority of domain scores were not normally distributed. To facilitate comparisons the medians (interquartile ranges) were calculated for all domains. ^gScores range from 0 to 23 where a higher score indicates better static and dynamic sitting balance and coordination of trunk movement. All data are means (standard deviation) unless stated otherwise.

Abbreviations: BBS, Berg Balance Scale; EQ-5D-5L, European Quality of Life 5 Dimensions Health Questionnaire; FES, Falls Efficacy Scale-International; FTSTS, Five Times Sit-to-Stand Test; FFST, Four Square Step Test; SIS, Stroke Impact Scale 3.0; TIS, Trunk Impairment Scale.