Falls after Stroke

Batchelor, Frances; Mackintosh, Shylie; Said, Catherine M; Hill, Keith

doi:10.1111/j.1747-4949.2012.00796.x

Cited by 268 publications

(216 citation statements)

References 105 publications

(175 reference statements)

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“…The occurrence of falls at 3, 6, and 12 months was similar to fall frequency previously reported among community-dwelling individuals post stroke. 1,3 Although limited by plausible healthy survivor or recall bias, findings indicate that occurrence of falls in our sample did not vary considerably between 3 months and 6 years post stroke; however, within subgroups, there was a variation in fall trends over time. For participants with no gait/balance disability at baseline, the odds for a fall increased during the 6-year period, whereas for participants with gait/balance disability at baseline, the odds decreased.…”

Section: Discussionmentioning

confidence: 91%

Occurrence and Predictors of Falls in People With Stroke

Minet

Peterson

Koch

et al. 2015

Stroke

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Background and Purpose— The purpose was to investigate the occurrence of self-reported falls in people with stroke at 3, 6, and 12 months and 6 years post stroke and predictors for falls during 6 years. Methods— A prospective study involving 121 people with stroke. Data were obtained through structured interviews and assessments. Generalized estimating equation modeling using proportional odds was used to explore the predictive value of fall history, functioning/disability, and personal factors during 6 years. Results— The proportion of fallers constituted of 35%, 26%, 33%, and 35% of the sample at 3, 6, and 12 months and 6 years of follow-up, respectively. Higher perceived effect of stroke on activities of daily living (odds ratio, 1.37; 95% confidence interval, 1.04–1.80), falls at 3 months (odds ratio, 1.0; 95% confidence interval, 1.01–3.94), and no gait/balance disability at baseline (odds ratio, 7.29; 95% confidence interval, 1.99–26.73) were predictors for future falls. During the 6 years, the odds for a fall decreased for participants with gait/balance disability at baseline but increased for those with no gait/balance disability. Conclusions— Results highlight the importance of performing fall risk evaluations over time among people with stroke, even when gait and balance functioning initially post stroke is good.

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Section: Discussionmentioning

confidence: 91%

Occurrence and Predictors of Falls in People With Stroke

Minet

Peterson

Koch

et al. 2015

Stroke

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“…Falls are a common complication after a stroke (Batchelor, Mackintosh, Said, & Hill, 2012) and have been associated with loss of function for people with acute stroke (Schmid et al, 2010). Approximately 73% of people returning to the community after stroke experience a fall during the first 6 mo (Forster & Young, 1995).…”

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confidence: 99%

Fear of Falling in People With Chronic Stroke

Schmid

Arnold

Jones

et al. 2015

The American Journal of Occupational Therapy

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OBJECTIVE. We assessed the prevalence of fear of falling (FoF) in a sample of people with chronic stroke and compared multiple variables (balance, anxiety, depression, activity and participation, and stroke severity) in people with and without FoF. METHOD. This study was a secondary analysis of data collected from a cross-sectional study of mobility after stroke in 77 participants with chronic stroke (>6 mo poststroke). RESULTS. Of the 77 participants, 51 (66%) reported experiencing FoF. People with FoF had significantly decreased balance (p < .001) and activity and participation (p = .006) and significantly increased anxiety (p = .007). People with FoF also had significantly worse stroke severity (p = .001). CONCLUSION. FoF is a prevalent concern in the chronic stroke population. The presence of FoF was associated with a variety of negative consequences. Occupational therapy practitioners should address FoF to help clients manage FoF and possibly improve recovery.

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“…[1][2][3][4][5] Individual risk factors for falls among stroke survivors are numerous and interrelated, 6 and can include impaired performance of activities of daily living, 1,3,4 inability to transfer, 7 decreased balance control, 5,8 and not following instructions. 2,9 Falls after stroke can have significant immediate physical and psychological consequences, 10 including injuries [2][3][4]11 such as hip fractures, 12 fear of falling, 13 reduced physical activity, 11 and depression. 14 In-hospital falls have been identified as one of the most common medical complications after stroke, 15,16 which can negatively influence stroke rehabilitation and recovery.…”

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confidence: 99%

Do Falls Experienced During Inpatient Stroke Rehabilitation Affect Length of Stay, Functional Status, and Discharge Destination?

Wong

Brooks

Mansfield

2016

Archives of Physical Medicine and Rehabilitation

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Objective-To compare length of stay, functional status, and discharge destination between individuals who fell during in-patient stroke rehabilitation and those who did not fall. Design-Retrospective cohort study. Setting-Rehabilitation hospital.Participants-Individuals who fell during in-patient stroke rehabilitation (n=106; fallers group; mean age=67.8 years, SD=12.9; mean time post-stroke=26.4 days, SD=28.3) were matched to individuals who did not fall (n=106; non-fallers group; mean age=67.3 years, SD=13.6; mean time post-stroke=21.9 days, SD=28.8) on age and functional status (N=212). Interventions-Not applicable.Main outcome measures-Total length of stay, Functional Independence Measure (FIM) assessed at discharge, and discharge destination.Results-The mean length of stay for fallers was 11 days longer than non-fallers (p=0.0017). Non-fallers and fallers did not differ on discharge total FIM scores (p=0.19), and both groups were discharged home after in-patient rehabilitation (non-fallers: 77%; fallers: 74%; p=0.52).Conclusions-This study suggests that falls experienced during in-patient stroke rehabilitation may have contributed to a longer length of stay; however, falls did not impact discharge functional status or discharge destination. In-patient rehabilitation is a health care setting where patients are focused on improving function and maximizing their abilities. It is typically delivered during the sub-acute stage of stroke recovery (i.e. less than three months post-stroke) when patients are likely to receive the most benefit from intensive therapy. 17,18 Unfortunately, there is limited available evidence for the effectiveness of falls prevention interventions after stroke across acute care, rehabilitation, community, and institutional care settings. 19,20 Thus, the incidence of falls will remain of concern, as it may not be possible to prevent every fall. KeywordsLittle evidence exists on the impact of falls on rehabilitation outcomes; therefore, it is important to understand the effect that falls have on the course of patient recovery and delivery of care during the critical sub-acute phase of stroke. The primary objective of this study was to compare length of stay, functional status, and discharge destination between individuals who fell during in-patient stroke rehabilitation and those who did not fall. It was hypothesized that patients who fell would have poorer recovery compared to those who did not fall. This would be demonstrated by a longer length of stay, worse functional outcomes at discharge, and less likely to be discharged home following the rehabilitation stay among individuals who fell. METHODS Study designA retrospective cohort study involving a chart review was conducted. The chart review involved consecutive admissions to the specialized stroke unit at the Toronto Rehabilitation Institute from October 1, 2009 to September 30, 2012. The Toronto Rehabilitation Institute Research Ethics Board approved this study, and a waiver of patient consent for the purpose of this review...

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Falls after Stroke

Cited by 268 publications

References 105 publications

Occurrence and Predictors of Falls in People With Stroke

Occurrence and Predictors of Falls in People With Stroke

Fear of Falling in People With Chronic Stroke

Do Falls Experienced During Inpatient Stroke Rehabilitation Affect Length of Stay, Functional Status, and Discharge Destination?

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