Falls and Osteoporosis Post-Stroke

Abstract

Falls are a common and serious, but potentially preventable, problem after stroke. Avoiding falls requires balance, which is a fl uid and dynamic physical skill. There are a number of perceptual, neurological, and mechanical mechanisms underlying our ability to balance, and they are complex and heterogeneous. Depending on where strokes occur in the brain, balance may be affected in different ways. It is important to identify stroke patients who are at risk of falls in order to optimize prevention, and a number of stroke-specifi c risk factors have been identifi ed, but the available assessment scales have only limited sensitivity and specifi city. If management of falls risk in stroke is to be effective, assessments have to identify the precise and individual mechanisms underlying balance problems, and then specifi c management has to be targeted at these defi cits. The consequences of falls after stroke can be severe and include loss of confi dence and loss of independence, as well as serious injury including fractures. Stroke patients are at greater risk of osteoporosis, particularly on the hemiplegic side, which occurs rapidly following paresis. Management of falls risk post-stroke should also include timely assessment of bone health and the associated fracture risk. Keywords Key Messages• Following a stroke, falls risk is increased over and above the falls risk associated with ageing. • The assessment of stroke patients who are at risk of falls should be multidisciplinary, so too should the delivery of interventions designed to prevent them. • Bone density is lost rapidly in the hemiparetic limb following a stroke, with resultant increased fracture risk.• Along with osteoporosis drug treatment, exercise, nutrition, and addressing falls risk are important strategies to reduce fracture risk.

A Novel sEMG Triggered FES-Hybrid Robotic Lower Limb Rehabilitation System for Stroke Patients

“…The fixture (7) was placed and adjusted to the size of the lower leg and foot and prepared to be attached to the robot's arm coupling (8). The isolated power supply ( 9) was used to ensure safety for the participant in the experimental setup.…”

“…Furthermore, stroke is a leading cause of acquired disability among adults, affecting 17 million people worldwide each year [2]. The most common impairment among more than half of all acute stroke patients is functional deficits in motor control [3] - [6], such as hemiplegia [7] and hemiparesis [8]. Just as stroke is occurring more frequently, so is the stroke-related burden of recovery and rehabilitation [3], [4].…”