Independently getting off the floor: a feasibility study of teaching people with stroke to get up after a fall

Abstract

Background: Falls are common among stroke survivors but many are not taught how to get up again. A technique from Action for Rehabilitation following Neurological Injury (ARNI) addresses this problem. We investigated the feasibility and safety of teaching this technique to stroke survivors. Methods: Stroke survivors (mean 7.1 years post-stroke) with mild-to-moderate disability (mean modified Rankin Score 2.4), who could get up with assistance but not independently, received up to six sessions of training to independently get off the floor (IGO). The primary outcome was IGO success; safety and feasibility were investigated by participant and trainer interviews, biomechanical and video analysis and expert panel review. Findings: Six of the 10 participants achieved IGO and five of nine retained the skill two months post-training. One to six sessions (median 3) were needed to master IGO; one minor but no serious adverse events occurred. Expert reviewers indicated training involved an acceptable risk of falls and no concerns for knee and wrist positions. Conclusions: This feasibility study indicates IGO may be useful. IGO was taught to and safely used by selected stroke survivors. Further assessment of IGO has now been part of a pilot randomised controlled trial of ARNI based stroke rehabilitation.

Knowledge, skills and attitudes of older people and staff about getting up from the floor following a fall: a qualitative investigation

“…One UK survey found that practical demonstrations were reported by only 14/231 (6%) of falls services [ 13 ], and UK audit data found in 2010 that only 4% of fallers in rehabilitation programmes were taught how to get up [ 14 ]. Anecdotally there appears to be some reluctance to teaching techniques for getting up off the floor - possibly due to a lack of confidence from both older people and therapists, although there is evidence that it is feasible and acceptable to teach this to inpatients, community-dwelling older people and stroke survivors [ 15 – 17 ]. One method commonly used, called “backward chaining” breaks the activity of getting down to and up from the floor into smaller steps, with the last step being taught and achieved first [ 18 ].…”