Evidence map›Paper›PMID 41876122›Full record

Trial reportBMJ (Clinical research ed.)2026

Home based, tailored intervention to reduce rate of falls after stroke (FAST): randomised trial.

Lindy Clemson, Katharine Scrivener, Natasha Lannin, Louise Ada, Sally Day, Ingrid Lin, Stephen Isbel, Anne Cusick, Benjamin Gardner, Elisabeth Preston and 3 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMJ (Clinical research ed.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Lindy ClemsonSydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia lindy.clemson@sydney.edu.au.ORCID 0000-0003-2687-1114
Katharine ScrivenerSchool of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.ORCID 0000-0003-0851-7023
Natasha LanninDepartment of Neurosciences, Monash University, Melbourne, VIC.ORCID 0000-0002-2066-8345
Louise AdaSydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.ORCID 0000-0003-1369-5721
Sally DaySydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.ORCID 0000-0002-1194-4360
Ingrid LinSchool of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.ORCID 0000-0002-3613-6992
Stephen IsbelCentre for Ageing Research and Translation, University of Canberra, Canberra, ACT, Australia.ORCID 0000-0001-5355-3205
Anne CusickSydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.ORCID 0000-0001-9614-1462
Benjamin GardnerSchool of Psychology, University of Surrey, Guildford, UK.ORCID 0000-0003-1223-5934
Elisabeth PrestonCentre for Ageing Research and Translation, University of Canberra, Canberra, ACT, Australia.ORCID 0000-0002-7918-824X
Gillian HellerNHMRC Clinical Trials Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.ORCID 0000-0003-1270-1499
Catherine M DeanSchool of Health Sciences and Nursing, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia.ORCID 0000-0001-7502-1138
FAST Study Group

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo investigate the effectiveness of a multidisciplinary, home based, tailored intervention to reduce falls after stroke.

designTwo armed, randomised trial.

settingThree states in Australia.

participantsPeople within 5 years of stroke, aged >50 years, discharged from formal rehabilitation to the community, and able to walk 10 m across flat ground with or without an aid. Those with moderate-to-severe receptive aphasia or walking speed >1.4 m/s without falls in the previous year were excluded.

interventionOver 6 months, the experimental group received a habit forming functional exercise, home fall hazard reduction, and goal directed community mobility coaching; the control group received usual care. Physiotherapist and occupational therapist dyadic teams worked collaboratively to deliver the intervention.

main outcome measuresThe primary outcome was rate of falls over 12 months. Secondary outcomes were proportion of participants having a fall, community participation, self-efficacy, balance, mobility, physical activity, activities of daily living, depression, and health related quality of life.

resultsBetween August 2019 and December 2023, 370 people with stroke were enrolled. At 12 months, a significant between group difference was seen in the rate of falls in favour of the experimental group, representing a 33% reduction in falls (incidence rate ratio 0.67, 95% confidence interval (CI) 0.48 to 0.94; P=0.02). No significant between group difference was seen in the number of participants having a fall (absolute risk reduction 0.03, 95% CI -0.07 to 0.13; P=0.52). The main between group differences in favour of the experimental group were in community participation (Late Life Function and Disability Instrument disability limitation: mean difference 3% (95% CI 1% to 6%); P=0.02), self-efficacy (mean difference 0.6 (0.2 to 1.0); P=0.004), mobility (fast walking speed: mean difference 0.13 (0.06 to 0.19) m/s (P<0.001); preferred walking speed: 0.06 (0.02 to 0.10) m/s (P=0.02)), and balance (Step Test: mean difference 0.06 (0.01 to 0.12) steps/s; P=0.03).

conclusionA tailored intervention prevented falls in community dwelling, ambulatory people with stroke. The decrease in the rate of falls was underpinned by clinically worthwhile improvements in self-efficacy, mobility, community participation, and balance.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12619001114134.

Indexed as

Accidental FallsExercise TherapyHome Care ServicesStrokeStroke RehabilitationActivities of Daily LivingAgedAustraliaFemaleHumansMaleMiddle AgedPostural BalanceQuality of LifeSelf Efficacy

Identifiers

PMID41876122
PMCPMC13010266

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.