Implementation of a Falls Prevention Program in Guyana: an International Collaboration to Improve Balance Confidence

Research Objectives: To investigate the effectiveness of an exercise program in improving function while reducing falls and fear of falling.

Design: Before-after trial of an exercise program developed through collaboration between researchers in Guyana and the US. The groups shared information about falls incidence and occurrence post-stroke, and developed an exercise program designed to reduce falls.

Setting: Palms Rehabilitation Department, Georgetown, Guyana

Participants: Convenience sample of twenty participants, ages 50-89 years, who had sustained a stroke, had a history of falls or scored less than 50/56 on the Berg Balance Scale. Subjects unable to follow directions were excluded. Time since stroke ranged from two weeks to ten years.

Interventions: An eight-week exercise program with exercises to address balance and function, considering Guyanese culture and physical environment in Georgetown, Guyana.

Main Outcome Measures: Questionnaire addressing frequency and fear of falling.

Results: Nineteen participants completed the study. Initially eleven participants were very concerned about falling, three were fairly concerned, two were not very concerned, three were not concerned at all, and one didn’t know. At the end, fifteen were not concerned at all, two were fairly concerned, one was very concerned about falling. All participants had sustained at least one fall prior to the study. Only one participant reported a fall during the program.

Conclusions: Collaboration to develop an evidence-based, culturally appropriate falls prevention program can help reduce fall risk and improve confidence for adults with acute and chronic stroke. The exercise program can be used clinically by physiotherapists in Guyana both in the department and as a home program to help improve function and reduce fall risk and fear of falling in persons post-stroke.

Author(s) Disclosures: This research was unfunded. There are no conflicts of interest for any of the presenters.