Background: Community mobility can be compromised post-stroke not only due to mobility limitations resulting from post-stroke impairments but additionally people may fear falling or feel they lack ‘permission’ to go out. The FAST trial provided an intervention aiming to reduce falls in stroke survivors by combining habit-forming exercise (LiFE) and home safety. An additional component focused on community mobility to align with clinical guidelines; aiming to enhance confidence and skills through a specific goal-directed plan.
Methods: A community mobility SMART goal, written in Goal Attainment Scale (GAS) format (scored -2, -1(baseline), 0, +1, +2), was developed by participants in conjunction with therapists (occupational therapist or physiotherapist). Goals were set week 3 of the multi-session intervention, community practice was included during intervention. Goals were analysed via content analysis to explore range and relevance, using descriptive statistics of GAS scores to illustrate outcome achievement, and contextualised with qualitative data from interviews.
Results: 131 personalised community goals were set (n=128 scored at 6-month, n=121 12-month). Content analysis identified 12 themes, including walking goals, counting goals, task complexity, situational specific goals and doing goals (i.e., purposeful activity). By six months 77% had met or surpassed their goal, at 12 months 64% were maintaining their goal. Participants felt their community goals provided them with motivation to engage in the functional exercise component of the intervention.
Conclusion: Setting goal-directed community goals is an important adjunct to a functional fall prevention program for stroke survivors. Individualised, practical goals support the translation of intervention gains into community connectedness