Therapists’ perspectives on adapting the Stepping On falls prevention programme for community-dwelling stroke survivors in Singapore

Purpose: This study investigates the perspectives of rehabilitation therapists on the implementation of fall prevention programs with community-dwelling stroke survivors in the Singapore context, and elicits recommendations to adapt the Stepping On program with stroke survivors.

Method: Qualitative data were elicited during 4 focus groups with 23 rehabilitation therapists (15 occupational therapists; 8 physiotherapists) who had received training to deliver the original Stepping On program, and had experienced delivery of fall-prevention intervention programs locally. Collected data was analysed using thematic analysis method.

Results: Three themes emerged from the focus groups describing: (a) limitations of existing falls prevention intervention for stroke clients; (b) the need to adapt the Stepping On program to use with stroke clients; and (c) challenges in implementing fall prevention programs in the stroke context. A series of new components were suggested to be included as part of the Stepping On after Stroke program, including involvement of family members and caregivers, and tailored community reintegration sessions (such as taking public transport and shopping).

Conclusion: Rehabilitation therapists describe challenges in addressing fall prevention within a stroke context, and findings highlight the need for a structured, stroke-specific fall prevention program rather than a more general approach to education and training. Contextual components identified provide valuable inputs towards the development of a culturally relevant fall prevention program for stroke survivors in Singapore.