Australian 'falls after stroke trial' sees 33% falls reduction in 12 months

Australian research published open access this month in The BMJ (doi: 10.1136/bmj-2025-085519) reports a 33% reduction in post-stroke falls rate following a tailored, home-based program. The ‘falls after stroke trial’, or FAST, is a program of functional exercise, preventing hazards around the home, and out-of-home mobility coaching and was led by researchers from the University of Sydney and Macquarie University with collaborators from Monash University and the University of Canberra.

The three components of the in-home program encompassed:

• Habit-forming exercise embedded into daily activities and designed to improve balance and strength — based on the Lifestyle-integrated Functional Exercise (LiFE) program.
• Fall hazard reduction focused on encouraging protective behaviours to reduce risk and adapting the home environment.
• Coaching participants towards a goal for mobility outside the home, such as through a shopping trip, using public transport or walking in a park.
   

According to the University of Sydney, FAST is the first study to show a non-drug intervention after stroke can effectively prevent falls. “More than twice as many people with stroke have falls compared with the general older population, and they are also likely to be repeat fallers,” said the lead author of the study, Professor Emeritus Lindy Clemson of the School of Health Sciences at the University of Sydney.

“Falls after stroke can lead to serious injury and hospitalisation, delaying recovery and rehabilitation, and jeopardising long-term health and wellbeing,” Clemson said. “The decrease we saw in the rate of falls among people receiving the active intervention program was underpinned by worthwhile improvements in their mobility, balance, community participation and self-efficacy.”

“By focusing on stroke survivors living in their communities and testing an intervention delivered in the home, we’ve ensured the intervention reflects something that can readily be implemented,” said Professor Catherine Dean of the School of Health Sciences and Nursing at Macquarie University, co-author of the study. “We believe our world-first finding could help reduce the global burden of falls after stroke.”

Image credit: iStock.com/seb_ra