The experiences of everyday activities post-stroke

In the United States, the incidence rate of new or recurrent stroke is approximately 795 000 per year, and stroke prevalence for individuals over the age of 20 years is estimated at 6.5 million.1 Mortality rates in the first 30 days after stroke have decreased because of advances in emergency medicine and acute stroke care. In addition, there is strong evidence that organized postacute, inpatient stroke care delivered within the first 4 weeks by an interdisciplinary healthcare team results in an absolute reduction in the number of deaths.2,3 Despite these positive achievements, stroke continues to represent the leading cause of long-term disability in Americans: An estimated 50 million stroke survivors worldwide currently cope with significant physical, cognitive, and emotional deficits, and 25% to 74% of these survivors require some assistance or are fully dependent on caregivers for activities of daily living (ADLs).4,5 Notwithstanding the substantial progress in acute stroke care over the past 15 years, the focus of stroke medical advances and healthcare resources has been on acute and subacute recovery phases, which has resulted in substantial health disparities in later phases of stroke care. Additionally, healthcare providers (HCPs) are often unaware of not only patients’ potential for improvement during more chronic recovery phases but also common issues that stroke survivors and their caregivers experience. Furthermore, even with evidence that documents neuroplasticity potential regardless of age and time after stroke,6 the mean lifetime cost of ischemic stroke (which accounts for 87% of all strokes) in the United States is an estimated $140 000 (for inpatient, rehabilitation, and follow-up costs), with 70% of first-year stroke costs attributed to acute inpatient hospital care1; therefore, fewer financial resources appear to be dedicated to providing optimal care during the later phases of stroke recovery. Because there remains a …

Objective: To identify and summarize studies that have implemented dietary behavior interventions and reported dietary outcomes in community-dwelling adult stroke survivors. Design: Scoping Review; Setting: Not applicable. Participants: Studies eligible for review included peer-reviewed studies describing both a dietary intervention and a dietary outcome among community-dwelling stroke survivors published between January 2000 and June 2022. Results: We identified 14 articles that included both a dietary behavior intervention and a dietary outcome. All studies (5 pilot randomized controlled trials (RCTs), 6 non-pilot RCTs, 3 cohort studies) delivered multimodal health behavior interventions that included a dietary component. Interventions were delivered weekly to every other month and lasted for 1-24months. Most studies did not use standardized assessments to assess dietary outcomes; however, 8 studies reported improvement in dietary outcomes. Conclusions: This review provides support for the efficacy of dietary behavior interventions in stroke survivors. Variability in intervention format and assessment measures across studies impedes the ability to conduct meta-analyses of outcomes to inform research knowledge and clinical practice. Additional research is needed to determine mechanisms-of-action for dietary behavior change in stroke survivors.

Background: Tai Chi exercise is known to improve health and well-being among older adults. Most Tai Chi studies conducted among stroke survivors have focused on physical functioning, whereas inclusion of stroke survivors’ feelings and perceptions of Tai Chi is lacking. Understanding the benefits and difficulties of participating in Tai Chi exercise from stroke survivors’ perspectives is important for healthcare providers to investigate. Objective: Using storytelling, we sought to identify stroke survivors’ feelings and perceptions of participating in a Tai Chi intervention during their post-stroke recovery. Methods: This descriptive qualitative study examined stories from community-dwelling stroke survivors, collected as part of a larger randomized clinical trial. Participants (n=17) were on average 71 years old (range=54-87 years) mainly men (65%); and had the option of writing their own story or having someone write it for them. To examine these stories, an inductive content analysis approach was used with a priori theoretical codes (and sub-codes): 1.) Feelings (confidence, enjoy, hopeful, helpful, other), and 2.) Perceptions of Impact (physical abilities, mental/cognitive abilities, challenges, other). Lincoln and Guba’s criteria were followed to ensure trustworthiness of the data. Results: When examining these stories, the majority of stroke survivors felt that participating in a Tai Chi intervention was helpful and enjoyable, and some felt improved confidence. Further, they perceived the impact of Tai Chi on their post-stroke recovery led to improved physical abilities, such as better balance and walking, along with fewer falls. Likewise, stroke survivors perceived that their mental and cognitive abilities improved due to learning a sequence of Tai Chi movements. There were no perceived challenges. Overall, they perceived the impact of Tai Chi helped them to be more independent, move forward, develop friendships and make connections in their communities again. Conclusions: Using storytelling, healthcare providers can discuss the benefits of Tai Chi and then relate the feelings and perceptions of other stroke survivors’ experiences to encourage engagement in regular physical activity to aid in the post-stroke recovery process.

Background and Aims: The major outcome of stroke rehabilitation is the recovery of the ability to walk. However, a large proportion of stroke survivors are discharged to the community with gait deficiency which impairs their functional independence, and quality of life increasing the burden of care on caregivers especially their lack of functioning in the community. This study assessed the gait functional performance in community-dwelling stroke survivors and explored its association with functional independence, quality of life, and community reintegration in community-dwelling stroke survivors. Materials and methods: This study involved 115(59 males and 56 females) community-dwelling stroke survivors. Their gait functional performance was assessed using the 10-meter walk test (10MWT) while their functional independence was assessed with the functional independence measure (FIM). Their quality of life (QoL) was assessed using the Stroke-specific QoL scale while community functioning and productivity were assessed using the community integration questionnaire (CIQ). Their scores on the assessments were compared with the normative data of their age and sex-matched healthy individuals. Data was analysed using Spearman’s correlation coefficient and Chi-Square at p<.05. Results: Participants’ ages ranged between 27 to 78 years (mean=60.48±37.84 years). More participants (56.7%) had right hemispheric lesions and 43.3% had lesions in the left hemisphere. Their gait function, functional independence performance, QoL, and community reintegration functions were significantly (p<0.05) lower than their age and sex-matched normative data. There was a significant (p<0.05) association and relationship between their gait functional performance and each of the functional independence performance, QoL, community reintegration, and productivity. Conclusion: Gait functional performance in community-dwelling stroke survivors is significantly lower than in age and sex-matched healthy individuals and it is significantly associated with low functional independence performance, low quality of life, poor community functioning, and lack of productivity in stroke survivors, Abnormal gait pattern is related to poor functional independence, poor quality of life and low productivity.

Background: Clinician interest in the role of tablet technology in commercially available tablet devices (i.e. iPads) following stroke is rising. Tablets have the potential to encourage engagement in therapeutic activities. We aimed to explore stroke survivor acceptability of and experience of tablet use during the first three months of stroke recovery. Design: A qualitative study using an inductive thematic approach incorporating the process of constant comparison was utilized to collect and analyse data. Setting: Community dwelling stroke survivors in metropolitan Newcastle, New South Wales, Australia. Participants: Twelve stroke survivors (8 male, 4 female; median age of 73 (IQR 58–83) years). Main outcome measures: Qualitative outcomes were participants’ perceptions using in-depth, semi-structured interviews. Results: Participants’ found tablets easy to use and beneficial. Most stroke survivors used the tablet to engage in therapeutic and leisure activities on most days during the three months. Three key themes emerged: (1) Getting established on the iPad: “It just became easier and easier”, (2) Technology as a means for increased stimulation: “Something to keep me interested”, and (3) Personal experiences of access to an iPad: “It’s been very helpful”. Conclusions: Incorporating tablet technology into the delivery of stroke rehabilitation appears to be feasible and acceptable at a patient level. This process has the potential to improve participation in therapeutic and or leisure; however further evaluation towards the impact of tablet technology on patient outcome and quality of life is required.Implications for RehabilitationThe use of tablet technology provides a platform to increase the variety and intensity of stroke therapy, both in the hospital setting and following discharge from hospital, facilitating physical, cognitive and social activity.Stroke survivors experienced increased participation in therapeutic activities, increased socialization and less inactivity and boredom through access to tablet technology.Tablet technology is feasible and acceptable at a patient level, providing preliminary support for the use of interactive computer devices during stroke recovery.

Purpose: To explore the experience of post-stroke fatigue in community-dwelling stroke survivors with and without post-stroke mood disturbance within one year of stroke. Methods: This was a prospective qualitative cohort study including semistructured interviews undertaken at baseline (stroke onset), 3, 6, 9 and 12 months in 23 stroke survivors; eight single interviews were held with “supplementary” participants. Qualitative data analysis involved an inductive thematic approach using a process of constant comparison. Results: Thirty-one participants (17 men, 14 women; age range 37–94 years) took part in 122 interviews. The majority of participants was independent and experienced few major depressive symptoms. Three trajectories emerged regarding the participants’ experiences of fatigue including experience of fatigue, coping strategies and knowledge. Conclusions: The results of this study suggest that in spite of reasonable objective physical recovery post-stroke, fatigue in community-dwelling stroke survivors may be disabling. The use of qualitative methodology was sensitive in identifying the factors that play a role in the experience of fatigue. The essential role of health professionals in this context is to provide support and education regarding fatigue and to promote participation after stroke in therapy programs. Routine practice for stroke services should include fatigue advice prior to discharge.Implications for RehabilitationIssues regarding fatigue are of major importance to stroke survivors.Allied health can play a significant role in providing training regarding management of fatigue symptoms to assist maintain community participation.Allied health professions have an important role in assisting stroke survivors to transition through feelings of loss and in providing education concerning new skills to assist manage symptoms of fatigue post-stroke.

Introduction: Health-related quality of life is a significant outcome of stroke survivors’ recovery. The 49-item English version of the Stroke Specific Quality of Life Scale (SSQOL) (Williams et al., 2009) is a stroke-specific assessment of stroke survivors’ health-related quality of life in 12 domains. However there has been no Chinese version of the scale for Chinese stroke survivors in Hong Kong. Aim: To examine the reliability and validity of the Chinese version of Stroke Specific Quality of Life Scale (SSQOL-C) in stroke survivors. Methods: SSQOL was translated into Chinese and blind back-translated by independent bilingual baccalaureate nursing students. Content validity was reviewed by an expert panel which consisted of one nurse academic, one nurse manager, three advanced practice nurses, and two registered nurses. A cross-sectional study was conducted to validate the translated version. A convenience sample of 135 adult stroke survivors were recruited from three community centres and a stroke support group in Hong Kong. Internal consistency analysis was performed. Pearson’s correlation coefficients were calculated between SSQOL-C, SF-36, and Frenchay Activities Index (FAI) to determine the convergent validity. Results: Content validity index of SSQOL-C was 0.99. SSQOL-C had high internal consistency with Cronbach’s alpha of 0.94 for the total scale, and between 0.65 and 0.90 for the 12 domains. The total SSQOL-C scores showed significant positive correlations with SF-36 physical health (r=0.58, p<0.01) and mental health (r=0.54, p<0.01) component scores, and FAI score (r=0.59, p<0.01). SSQOL-C physical subtotal scores showed significant positive correlations with SF-36 physical health (r=0.55, p<0.01) and mental health (r=0.43, p<0.01) component scores, and FAI score (r=0.54, p<0.01). SSQOL-C psychosocial subtotal scores showed significant positive correlations with SF-36 physical health (r=0.52, p<0.01) and mental health (r=0.56, p<0.01) component scores, and FAI score (r=0.56, p<0.01). Conclusion: The results showed SSQOL-C had good content and convergent validity, and reliability in Chinese stroke survivors. Further evaluation of factor structure of SSQOL-C will be conducted to determine its validity.

Background Many stroke survivors do not regain full function of their upper limb, which can have a devastating effect for participation in daily activities. Objectives This research aimed to systematically review stroke survivors’ lived experiences of upper limb recovery. Our objectives explored stroke survivors’ barriers and facilitators to recovery and the clinical implications for health professionals. Methods We searched the databases of MEDLINE, EMCARE, CINAHL, Scopus, and Web of Science using keywords and synonyms of ‘stroke survivors’, ‘upper limb’, ‘recovery’, and ‘perspectives’. Studies were appraised using the Critical Appraisal Skills Programme (CASP) Qualitative checklist. Data were analyzed descriptively and analytically using a thematic synthesis approach. We graded the emerging descriptive themes using the Confidence in the Evidence from Reviews of Qualitative Research (GRADE-CERQual). A protocol was registered apriori in PROSPERO (ID:181379). Results Eleven studies were included for review. Nine descriptive themes and three analytical themes emerged from the data that influenced upper limb recovery: 1) psychological wellbeing, 2) rehabilitation, and 3) relationships. Conclusions Barriers to upper limb recovery included health professionals’ attitudes particularly towards a lack of inclusivity in goal setting. In addition, stroke survivors perceived therapists focused on upper limb compensation rather than functional recovery, which was disempowering. Facilitators that enhanced recovery included the stroke survivors’ personal attitudes (psychological well-being) and external supports from family, friends, health professionals, and stroke survivor peers. Such supports enhanced the stroke survivors’ journey towards acceptance and adapting to their ‘new normal’ thus building confidence and self-efficacy to re-establish identity.

Stroke is the third leading cause of death and a major cause of disability in the United States. Individuals experiencing a completed stroke are faced with a multitude of challenges to restore their highest quality of life within the limitations of residual impairment. This research synthesis provides a summary of previous research on quality of life for stroke survivors. Research studies for inclusion in the review were identified by conducting a search of computerized databases through August 2000 and by using the ancestry method of reviewing reference lists from relevant publications. Thirty-nine studies were identified that focused on stroke survivors' quality of life during the recovery process. Stroke survivors' overall quality of life varied based on the country where the study was implemented. Variables positively associated with stroke survivors' quality of life were independence with activities of daily living, increased functional ability, social support, and healthcare resources. Variables negatively associated with stroke survivors' quality of life were psychological impairment, severity of impairment, severity of aphasia, inappropriate reactions to illness and pessimism, and inability to return to work. Specifically, 22% to 73% of the variance in stroke survivors' quality of life was primarily explained by presence of depression; functional ability, especially the upper extremities; and socialization, in particular, leisure activities. Implications for professional nursing practice to enhance stroke survivors' quality of life include encouraging independence, managing depression, and fostering interpersonal relationships. Areas for future research include longitudinal studies, rigorous psychometric assessment of quality of life instruments, and intervention studies.

Background: Despite policies promoting transport inclusivity, persons with disabilities in South Africa experience difficulties when accessing public transport. Poor community mobility hampers community integration and participation in occupations outside the home. This article describes the psychosocial community mobility experiences, of stroke survivors using wheelchairs in a town in the Western Cape province of South Africa. Method: The study used a descriptive qualitative design. The study population were community dwelling stroke survivors, from Worcester, using wheelchairs. Data was collected from eight participants through semi-structured telephonic interviews. Inductive thematic analysis was used. Findings: The four themes derived from the data were: Freedom of movement (My power chair, my Ferrari’), Social anxiety (People stare at you like they do not have a heart), Dependency (I must dance along to his fiddle), and Social isolation (You feel done in, dejected). Participants identified wheelchairs, private vehicles, and mini-bus taxis as modes of community mobility. Conclusion: When transport barriers prevent dignified, spontaneous community integration negative psychosocial consequences (social anxiety, dependency, and social isolation) followed. Community mobility barriers hampered participants’ ability to participate in meaningful occupations and left them isolated. Occupational therapists should take cognisance of the community mobility challenges wheelchair users might experience and implement intervention strategies to mediate these. Implications for practice • Community mobility is essential to perform occupations outside the residential setting and must be included in occupational therapy assessment and intervention strategies. • Occupational therapists can empower individuals with mobility impairments with the life skills to manage psychological challenges caused by accessing public transport and decreased community mobility. • Occupational therapy intervention for wheelchair users accessing public transport should include effective, appropriate transfer strategies to embark and disembark from minibus taxis. • In certain circumstances the occupational therapist should consider the possibility of a motorised wheeled mobility device to facilitate community integration: The study used a descriptive qualitative design. The study population were community dwelling stroke survivors, from Worcester, using wheelchairs. Data was collected from eight participants through semi-structured telephonic interviews. Inductive thematic analysis was used. Findings: The four themes derived from the data were: Freedom of movement (My power chair, my Ferrari’), Social anxiety (People stare at you like they do not have a heart), Dependency (I must dance along to his fiddle), and Social isolation (You feel done in, dejected). Participants identified wheelchairs, private vehicles, and mini-bus taxis as modes of community mobility. Conclusion: When transport barriers prevent dignified, spontaneous community integration negative psychosocial consequences (social anxiety, dependency, and social isolation) followed. Community mobility barriers hampered participants’ ability to participate in meaningful occupations and left them isolated. Occupational therapists should take cognisance of the community mobility challenges wheelchair users might experience and implement intervention strategies to mediate these. IMPLICATIONS FOR PRACTICE: • Community mobility is essential to perform occupations outside the residential setting and must be included in occupational therapy assessment and intervention strategies. • Occupational therapists can empower individuals with mobility impairments with the life skills to manage psychological challenges caused by accessing public transport and decreased community mobility. • Occupational therapy intervention for wheelchair users accessing public transport should include effective, appropriate transfer strategies to embark and disembark from minibus taxis. • In certain circumstances the occupational therapist should consider the possibility of a motorised wheeled mobility device to facilitate community integration

Introduction: Stroke survivors may face challenges in managing their psychosocial functions. However, little is known about psychosocial experiences and needs of community-dwelling stroke survivors, particularly in China. Purpose: This study explored the experiences and needs of psychosocial recovery among Chinese community-dwelling stroke survivors. Methods: Semi-structured and individual interviews were conducted with participants in Macao from community healthcare centers and supported groups using convenience sampling. Participants were asked about their experiences, challenges, and strategies for managing post-stroke psychosocial functions, and desired support for psychosocial recovery. Interview data were transcribed verbatim and analyzed thematically. Results: Twenty-six participants (mean age: 69.96±14.06 years old; mean post-stroke duration: 83.88±66.8 months) were recruited to participate in interviews. Regarding the experiences and challenges, most participants faced obstacles in managing emotions and barriers to rebuilding social lives due to the impacts of physical disabilities. Generally, most participants recognized that they were a minority of people in society, and some experienced further invalidation by society. The majority of participants lost motivation and expectations to face challenges, hesitated to disclose their conditions to others, and had less confidence in social interactions as they felt that they were different from others. Meanwhile, some participants adopted strategies to improve their psychosocial functions, including appreciation for oneself and important persons or events supporting them, adjustments to the disparity between expectations and reality, and reinterpretations of unpleasant experiences. Furthermore, communal creative activities offered by health professionals and peer support were recommended. Conclusion: To promote post-stroke psychosocial recovery in communities, health professionals should consider designing meaningful group activities for stroke survivors to meet their psychosocial needs. These findings will guide the development of interventions for enhancing psychosocial functions among Chinese community-dwelling stroke survivors.

Review question This systematic review is undertaken to answer the following review question: ‘What is the effectiveness of theory-based self-management programs for community-dwelling stroke survivors in promoting their post-stroke recovery after discharge from hospitals?’ Review objectives The objective of this systematic review is to present the best available research evidence pertaining to the effectiveness of theory-based self-management programs for community-dwelling stroke survivors to promote post-stroke recovery. An effective community-based self-management program with a theoretical basis for stroke survivors is crucial to optimize their physical, psychological and social outcomes of post-stroke recovery after discharge from hospitals, and ultimately to enhance the prognosis of stroke recovery. Population: All community-dwelling stroke survivors, aged 18 years or above, with first-ever or recurrent stroke. Intervention: All studies that examined the effectiveness of a structured self-management program designed with a theoretical basis for improving post-stroke recovery of community-dwelling stroke survivors. Comparison: A self-management program based on a theory that is different from the theory used for the intervention group; a self-management program without a theoretical basis; conventional or usual care; or no intervention. Outcomes: Primary outcomes: - Quality of life - Self-management behaviours Secondary outcomes: - Physical outcomes: activities of daily living - Psychological outcomes: depression, self-efficacy - Social outcomes: community reintegration, perceived social support The specific review objectives are to: (1) Determine the effectiveness of theory-based self-management programs in enhancing quality of life of community-dwelling stroke survivors (2) Determine the effectiveness of theory-based self-management programs in facilitating the participation of community-dwelling stroke survivors in stroke self-management behaviours. (3) Determine the effectiveness of theory-based self-management programs in improving physical outcomes of community-dwelling stroke survivors. (4) Determine the effectiveness of theory-based self-management programs in improving psychological functioning of community-dwelling stroke survivors. (5) Determine the effectiveness of theory-based self-management programs in improving social functioning of community-dwelling stroke survivors.

We assessed gender-specific factors associated with suicidal ideation among community-dwelling stroke survivors. In total, 4,322 stroke survivors who participated in the 2013 Korean Community Health Survey were included in the final analysis. Sociodemographic information, socio-family relationships, health behaviors, health status, and suicidal ideation were assessed using a standardized questionnaire. On fully adjusted analysis, suicidal ideation among males was more common in those who were widowed, rather than married (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.03–2.47), those who rarely contacted neighbors (OR 1.50, 95% CI 1.10–2.06), current smokers (OR 1.54, 95% CI 1.03–2.29), and frequent drinkers (OR 1.54, 95% CI 1.05–2.24). Suicidal ideation among females was more common in older subjects, those with lower monthly household incomes, the unemployed (OR 1.75, 95% CI 1.21–2.53), and housewives/students (OR 1.46, 95% CI 1.06–2.03), those who rarely contacted friends (OR 1.43, 95% CI 1.12–1.82), and diabetics (OR 1.35, 95% CI 1.05–1.73). Perceived persistent high-level stress, depressive mood, poor self-rated health, and a diagnosis of depression were commonly associated with suicidal ideation in both genders. Gender differences should be considered by medical practitioners and community policymakers when seeking to prevent and manage suicidal ideation in stroke survivors.

Introduction: Growing evidence suggested that visual arts-based interventions contributed to improvements in psychosocial functioning among stroke survivors. However, such interventions examining in previous evidence were mainly conducted in the in-patient settings. This might limit access by community-dwelling stroke survivors. Purpose: This study aimed to evaluate the feasibility and impact of a visual arts-based intervention on promoting psychosocial functioning of community-dwelling stroke survivors. Methods: A two-arm randomized controlled trial was conducted. Adults with stroke were recruited from community centers and support groups. Participants in the intervention group received the visual arts-based intervention grounded on Bandura’s principles of self-efficacy, involving a four-week, face-to-face, 90-mintue weekly group session, led by a trained registered nurse. A workbook with four sources of enhancing self-efficacy and successful stroke recovery experience shared by peers with stroke was also provided. Targeted outcomes, with general self-efficacy as the primary outcome, along with the secondary outcomes, including psychological distress, social participation, and health-related quality of life, were assessed immediately and one-month after completing the intervention. The generalized estimating equations model was adopted to compare the differences in outcomes between the intervention and control groups across time points relative to baseline. Results: A total of 144 stroke survivors (mean age: 68.41, SD: 11.64) were recruited and randomly allocated to intervention (n=72) and control (n=72) groups (attrition rate: 10.42%). The mean duration of the group session was 82.46 minutes (SD: 15.75). The generalized estimating equations analysis showed that participants in the intervention group had greater improvements in general self-efficacy, social participation, and health-related quality of life, as well as decrease in psychological distress in both follow-up assessments compared with the control group. Participants were satisfied with their involvement in the intervention, which rated the aspects of content, usefulness, material, facilitator, and arrangement of the intervention with a mean score exceeding 3.3 out of 5 for each item. Conclusion: The results showed the benefits of visual arts-based intervention for stroke recovery. It is worthwhile to further explore its longer-term effects as a community program for community-dwelling stroke survivors.

A fall after a stroke is common but the consequences can be devastating not only for the stroke survivors, but also for caregivers, healthcare, and the society. However, research on falls prevention among the stroke population are limited, particularly on home hazards assessment and home modifications, demanding for a study to be conducted. The aim of the study is to validate the protocol and content of a home hazard management program guided by the Person-Environment-Occupation (PEO) Model for falls prevention among community dwelling stroke survivors. Researchers developed their own questionnaire for content validation which consist of 23 items that covers two domains, namely justification for telehealth home hazard management practice and the protocol's overall methodology. Occupational therapists with at least one year of experience in conducting a home hazard assessment were consulted for the content validation of a two-group clinical controlled trial protocol utilizing a home hazard assessment, home modifications and education over the usual care. Written consent was obtained prior to the study. The occupational therapists were given a Google Form link to review the protocol and intervention based on the questionnaire and rated each item using a four-point Likert scale for relevance and feasibility. Open-ended feedback was also recorded on the google form. Content Validity Index (CVI), Modified Kappa Index and Cronbach's Alpha was calculated for the content validity and reliability analysis. A total of sixteen occupational therapists participated in the study. 43.7% of participants had a master's degree, 93.7% worked in the government sector and 56.2% had six years and more experience on conducting home hazard assessments. Content validity of the protocol is satisfactory for relevancy and feasibility (CVI = 0.84, ranging from 0.5 to 1.00), and for the reliability (α = 0.94 (relevance) and α = 0.97 (feasibility), respectively. The Modified Kappa ranged from 0.38 to 1.00 for all items. Feedback was also received regarding the design and procedure of the study protocol which included participant's selection criteria, sample size, equipment provided, cost, location, and care for the participants during the intervention. Introducing a home hazard management program to prevent falls among the stroke population is viewed relevant and feasible. Practical suggestions from the consultation panel were adopted, and minor adjustments were required to strengthen the protocol's overall methodology. This study established a rigorous and robust experimental protocol for future undertaking.