Relative importance of rehabilitation therapy characteristics on functional outcomes for persons with stroke .
The effectiveness of a community-based program for reducing the incidence of falls in the elderly: a randomized trial.
OBJECTIVES To test whether Stepping On , a multifaceted community-based program using a small-group learning environment , is effective in reducing  falls in at-risk people living at home . DESIGN A r and omized trial with subjects followed for 14 months . SETTING The interventions were conducted in community venues , with a follow-up home visit . PARTICIPANTS Three hundred ten community residents aged 70 and older who had had a fall in the previous 12 months or were concerned about falling . INTERVENTION The Stepping On program aims to improve fall self-efficacy , encourage behavioral change , and reduce falls . Key aspects of the program are improving lower-limb balance and strength , improving home and community environmental and behavioral safety , encouraging regular visual screening , making adaptations to low vision , and encouraging medication review . Two-hour sessions were conducted weekly for 7 weeks , with a follow-up occupational therapy home visit . MEASUREMENTS The primary outcome measure was falls , ascertained using a monthly calendar mailed by each participant . RESULTS The intervention group experienced a 31 % reduction in falls ( relative risk (RR)=0.69 , 95 % confidence interval (CI)=0.50 - 0.96 ; P=.025 ) . This was a clinical ly meaningful result demonstrating that the Stepping On program was effective for community-residing elderly people . Secondary analysis of subgroups showed that it was particularly effective for men ( n=80 ; RR=0.32 , 95 % CI=0.17 - 0.59 ) . CONCLUSION The results of this study renew attention to the idea that cognitive-behavioral learning in a small-group environment can reduce falls .  Stepping On offers a successful fall-prevention option
Relative importance of rehabilitation therapy characteristics on functional outcomes for persons with stroke .