Walking More, Falling Less – A Researcher’s Mission to Stop Stroke Survivors Hitting the GroundWalking More, Falling Less – A Researcher’s Mission to Stop Stroke Survivors Hitting the Ground
Recovery After Stroke
Stroke researcher Kate Scrivener talks with Bill Gasiamis about intensive community walking programmes and tailored fall-prevention exercise for stroke survivors who’ve left formal rehab. Their chat looks at what actually worked, why the evidence base is still tiny, and how personalised strategies can help people walk more and hit the ground less often.
59:53•22 Jun 2026
Walking More, Falling Less: Stroke Rehab That Finally Fits Real Life
Episode Overview
- A very intensive walking programme (43 hours over three weeks) was feasible for chronic stroke survivors, with high attendance and strong engagement.
- Improvements in walking speed matter because they’re closely tied to what someone can actually do in daily life, from house-only walking to full community mobility.
- Tailored, exercise-based fall prevention (including balance, strength and home/community safety work) can reduce how often stroke survivors fall, even if it can’t stop falls entirely.
- One-size-fits-all exercise programmes may help more able walkers but can increase falls in slower, more impaired survivors, highlighting the need for individualised approaches.
- Huge gaps remain between available research and everyday practice, so stroke survivors questioning their therapists and asking about new evidence can make a real difference.
“From that entire global body of literature, only three trials met the criteria. Three.”
What are the common struggles and victories in addiction recovery? Swap alcohol for stroke rehab and you’ll hear a very similar story in this conversation about fear, falls and finding your feet again. Stroke rehabilitation researcher Associate Professor Kate Scrivener joins host Bill Gasiamis to talk about two big projects: a high‑dose community walking programme and a major review of exercise programmes aimed at cutting fall rates after stroke.
The focus is stroke survivors who’ve finished formal rehab and are back in the community, often with little or no ongoing support. First up is "HiWalk" – three hours of walking a day, five days a week, for three weeks. Bill jokes that 43 hours of walking "is a massive effort for anybody" and Kate admits she was surprised by how strongly people showed up. Participants attended 91% of sessions and managed more than 500 steps an hour.
Crucially, walking speed improved, which, as Kate explains, links directly to real‑life freedom: house‑only walking, local outdoor walking, or moving around the wider community. The second strand is fall prevention. Kate’s new review of global research on exercise-based fall prevention for stroke survivors found just three qualifying trials, all from Australia. As Bill puts it, "stroke survivors fall at roughly twice the rate of the general population" yet there’s so little targeted evidence.
Kate’s own FAST trial cut falls by 33% using tailored, habit-based balance and strength work, plus home and community safety strategies. You’ll also hear candid talk on why one-size-fits-all programmes can actually increase falls in more impaired survivors, why guidelines alone don’t change practice, and how funding and system complexity hold back good ideas.
If you or someone you love is worried about walking more and falling less after stroke, this conversation might spark some new questions to take to your rehab team. What would a programme that truly fits your life look like?
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