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The face arm speech test: does it encourage rapid recognition of important stroke warning symptoms?
  1. Thompson G Robinson1,2,
  2. Ann Reid3,
  3. Victoria Joanna Haunton1,
  4. Andrew Wilson4,
  5. A Ross Naylor1,3
  1. 1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
  2. 2NIHR Biomedical Research Unit for Cardiovascular Sciences, University of Leicester, UK
  3. 3Department of Vascular Surgery, University Hospitals of Leicester NHS Trust, Leicester, UK
  4. 4Department of Health Sciences, University of Leicester, Leicester, UK
  1. Correspondence to Professor A Ross Naylor, Consultant Vascular Surgeon, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Infirmary Square, Leicester, LE1 5WW, UK; ross.naylor{at}


Objectives To assess public knowledge of stroke and transient ischaemic attack symptoms, and awareness of the content of a recent national health campaign.

Design Interviewer-administered questionnaire.

Setting Leicester, UK.

Participants 1300 members of a mixed urban/rural, multiethnic population that was sampled in public areas, places of work and schools.

Main outcome measures Knowledge of the terms ‘stroke’, ‘stroke risk factors’ and the ‘FAST campaign’. Awareness of stroke symptoms, and ability to distinguish from non-stroke symptoms.

Results 70% of the public surveyed were aware of the FAST campaign, with highest penetration in the female, older and white population. Overall, high levels of awareness of FAST symptoms (facial weakness 89%, arm weakness 83%, speech problems 91%) as warning signs of stroke were observed, though significantly lower levels were reported in the black and minority ethnic population. However, poor recognition of other important signs, including leg weakness (57%) and visual loss (44%) were seen, and significantly more men were likely to report non-specific symptoms as being associated with stroke.

Conclusions The survey has confirmed the effectiveness of the recent FAST campaign in raising public awareness of stroke and stroke warning signs, though poorest penetration was seen in the black and minority ethnic population. However, important stroke symptoms, including leg weakness and visual loss, were poorly recognised. This may lead to delays in presentation, specialist assessment and secondary prevention, and such stroke warning signs should be included in future public health campaigns.

  • FAST
  • transient ischaemic attack
  • stroke
  • symptom awareness
  • thrombolysis
  • aged
  • neurology
  • nursing home care
  • primary care

Statistics from


  • Funding The study was funded by a Regional Innovation Award from the East Midlands Strategic Health Authority (2009, 346).

  • Competing interests The authors declare: no support from any organisation for the submitted work; TGR has received an honorarium from Boehringer Ingelheim; no other relationships or activities that could appear to have influenced the submitted work.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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