Circumstances and consequences of falls among people with chronic stroke

Abstract

Abstract-Falls are common after stroke; however, circumstances and consequences are relatively unknown. Our objectives were to identify the differences between fallers and non-fallers among people with chronic stroke, identify the circumstances of fall events, and examine the consequences of the falls. This is a secondary data analysis; all participants included sustained a stroke. Variables included demographics, stroke characteristics, and comorbidities. Falls were collected via self-report, and circumstances and consequences were derived from participant description of the event and categorized as appropriate. Among 160 participants, 53 (33%) reported a fall during the 1 yr period. Circumstances of falls were categorized as intrinsic or extrinsic. Location and circumstance of the fall were included: 70% occurred at home and 40% were associated with impaired physical or mental state (e.g., inattention to tying shoes). Additionally, 21% of falls were associated with activities of daily living and mobility and 34% with slips or trips. The majority who fell sustained an injury (72%). Injuries ranged from bruising to fractures, and 55% of those with an injury sought medical care (32% to emergency department). Poststroke falls are associated with an alarming rate of injury and healthcare utilization. Targeting mental and physical states may be key to fall prevention.

Assessing Plantar Sensation in the Foot Using the Foot Roughness Discrimination Test (FoRDT): A Reliability and Validity Study in Stroke

“…Validity was further supported by the ability of the FoRDT to discriminate between stroke participants who reported falling compared with those who did not and the strong correlations demonstrated between roughness discrimination thresholds and dynamic balance. With respect to this, our novel measure performed favorably compared with a range of other sensory measures, including the EmNSA, Q‐tip cotton bud, and pin‐prick detection as part of the National Institutes of Health Stroke Scale (NIHSS), all of which showed weak and nonsignificant correlations with falls incidence or balance disability. This suggests that existing measures of sensory detection, widely used in clinical practice, may be inadequate for uncovering the complexities of sensory performance following central nervous system injury and that novel measures such as the FoRDT are required to further elucidate our understanding in this area.…”

“…Receiver operator characteristic (ROC) curve analysis was used to generate the area under the curve (AUC) or concordance (c‐statistic) to give a direct quantitative measure of the ability of FoRDT scores to discriminate between the respective groups (ie, control/stroke and stroke fallers/stroke nonfallers). Stroke participants were categorized as fallers if they reported at least one fall within the previous 3‐month period …”

A Case-Control Study of the Effectiveness of Tissue Plasminogen Activator on 6 Month Patients—Reported Outcomes and Health Care Utilization

“…(29-31) Modified Rankin Scale scores were dichotomized to those with good outcome (scores of 0 or 1) and those with poor outcome (scores of 2 or higher). Additional items in the survey included questions about falls,(32-34) return to driving and return to work. (35)…”

Enfoques del ejercicio terapéutico sobre la espasticidad en miembro inferior post-Enfermedad Cerebro Vascular: revisión sistemática

“…Además, estos problemas repercuten en el control y la coordinación de la extremidad durante la marcha 17,18 generando dependencia funcional y riesgos de posibles caídas 12 . Schmid, et al 19 , encontraron que el 36% de las caídas en personas post-ECV sucedió mientras realizaban AVD como aseo y vestido, el 21% reportó caídas caminando o subiendo y bajando escaleras, mientras el 34% tropezaron o se resbalaron.…”