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Objective: This study is aimed at translating the Home Falls and Accidents Screening Tool (HOME FAST) into the three main languages spoken in Malaysia and investigating its reliability through an alternative technology-based evaluation. Methods: Translation into three languages and cross-cultural adaptation of the HOME FAST was conducted via the five steps adopted from the Mapi Institute. For interrater reliability, occupational therapists who attended a face-to-face home hazard workshop were recruited. Each therapist rated the HOME FAST by using the provided combination of videos and photographs of stroke survivors manoeuvring in their home. For test-retest reliability, the same occupational therapists were invited to rate the same combination of photographs and videos again. Reliability was analysed using Gwet's AC1 and Bland and Altman's plot to describe agreement. Results: The translation challenges were minimal and rectifiable. A Bahasa Melayu, Mandarin, and Tamil versions of the HOME FAST were developed. Overall interrater reliability for both video (AC1 = 0.91) and photograph (AC1 = 0.91) were good. The test-retest reliability yielded similar outcome (video: overall AC1 = 0.92 and photograph: overall AC1 = 0.93). Conclusion: Using alternative technology (video and photograph) to do a home hazard assessment was feasible. However, the asynchronous nature of these methods has limitations in clarifying certain aspects in the home. Moving forward, potential investigation on other technologies such as telehealth for synchronous and real-time interaction is warranted.

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Background: Research on rehabilitation for falls after stroke is warranted. However, published evidence on fall interventions with stroke survivors is limited and these are mainly international studies that may be less relevant for Southeast Asia. Objective: This review aims to systematically identify literature related to stroke rehabilitation for falls and risk of falls in Southeast Asia. Methods: A scoping review with stakeholders' consultation was implemented. An electronic search was conducted up to December 2020 on 4 databases (Medline, CINAHL, Scopus, ASEAN Citation Index). Only original studies conducted in Southeast Asia were selected. Results: The initial search yielded 3,112 articles, however, only 26 were selected in the final analysis. Most of the articles focused on physical rehabilitation and implemented conventional therapies. While the literature may reflect practice in Southeast Asia, stakeholders perceived that the literature was inadequate to show true practice, was not informative and missed several aspects such as functional, cognitive, and psychological interventions in managing falls. Individual-centric interventions dominated the review while community-based and environmental-focused studies were limited. Majority of the articles were written by physiotherapists while others were from physicians, occupational therapists, and an engineer but few from other healthcare practitioners (i.e., speech therapists, psychologists) or disciplines interested in falls. Conclusions: Falls prevention among stroke survivors has received a lack of attention and is perceived as an indirect goal in stroke rehabilitation in Southeast Asia. More innovative research adopted from falls research with older people is needed to advance falls prevention and intervention practice with stroke survivors.

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Static pinch strength against a therapist's gentle pull is evaluated using the pincer grasp component of the Fugl Meyer Assessment (FMA) to assess pinch impairment after stroke. In the pincer grasp component, therapists applied a gentle pull to distinguish between a score of 1 (moderate pinch impairment) and a score of 2 (no pinch impairment). The gentle pull is described as a resistance equivalent to a manual muscle test (MMT) score 4/5. The accepted use of "gentle" as a qualitative description for the pull results is a non-standardized subjective interpretation. The goal of this paper was to determine the quantitative value of the gentle pull applied by the therapists as in their clinical practice using a pinch-pull gripping system. The FMA protocol was used to standardize the body and fingers positions of three occupational therapists who were then instructed to apply a gentle pull of 4/5 MMT using their thumb and index fingers (in a tip-to-tip pinch). The results show that the therapists exerted a mean gentle pull (4/5 MMT score) of 6.34 ± 0.98 N with high reliability and acceptable repeatability. In investigating the ability of healthy subjects to resist the gentle pull, 50 adult male volunteers were instructed to pinch the pincer object and resist a dynamic loading exerted by the pinch-pull gripping system as much as possible to the moment the pincer object slips away. The results show that all subjects were able to exert a pulling force higher than the quantitative value of the gentle pull.

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BACKGROUND: The technological intervention is considered as an adjunct to the conventional therapies applied in the rehabilitation session. In most high-income countries, technology has been widely used in assisting stroke survivors to undergo their treatments. However, technology use is still lacking in Southeast Asia, especially in middle- and low-income countries. This scoping review identifies and summarizes the technologies and related gaps available in Southeast Asia pertaining to stroke rehabilitation. METHODS: The JBI manual for evidence synthesis was used to conduct a scoping study. Until September 2021, an electronic search was performed using four databases (Medline, CINAHL, Scopus, ASEAN Citation Index). Only the studies that were carried out in Southeast Asia were chosen. RESULTS: Forty-one articles were chosen in the final review from 6,873 articles found during the initial search. Most of the studies reported the implementation of technological intervention combined with conventional therapies in stroke rehabilitation. Advanced and simple technologies were found such as robotics, virtual reality, telerehabilitation, motion capture, assistive devices, and mobility training from Singapore, Thailand, Malaysia, and Indonesia. The majority of the studies show that technological interventions can enhance the recovery period of stroke survivors. The consultation session suggested that the technological interventions should facilitate the needs of the survivors, caregivers, and practitioners during the rehabilitation. CONCLUSIONS: The integration of technology into conventional therapies has shown a positive outcome and show significant improvement during stroke recovery. Future studies are recommended to investigate the potential of home-based technological intervention and lower extremities.

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