How to Identify Potential Fallers in a Stroke Unit: Validity Indexes of 4 Test Methods

Andersson, Åsa; Kamwendo, Kitty; Seiger, Åke; Appelros, Peter

doi:10.1080/16501970500478023

Cited by 194 publications

(200 citation statements)

References 20 publications

(24 reference statements)

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“…Better results were revealed for distinguishing nonrepeated from repeated fallers than nonfallers (NFs) from fallers (Fs). Andersson et al 8 confirmed the test's predictive value in subacute patients.…”

supporting

confidence: 53%

Gait Analysis With Cognitive-Motor Dual Tasks to Distinguish Fallers From Nonfallers Among Rehabilitating Stroke Patients

Baetens

Kegel

Palmans

et al. 2013

Archives of Physical Medicine and Rehabilitation

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This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues.Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. Abstract Objectives: To evaluate fall risk in stroke patients based on single-and dual-task gait analyses, and to investigate the difference between 2 cognitive tasks in the dual-task paradigm. Design: Prospective cohort study. Setting: Rehabilitation hospitals. Participants: Subacute stroke patients (NZ32), able to walk without physical/manual help with or without walking aids, while performing a verbal task. Interventions: Not applicable. Main Outcome Measures: Functional gait measures were Functional Ambulation Categories (FAC) and use of a walking aid. Gait measures were evaluated by an electronic walkway system under single-and dual-task (DT) conditions. For the single-task, subjects were instructed to walk at their usual speed. One of the DTs was a verbal fluency dual task, whereby subjects had to walk while simultaneously enumerating as many different animals as possible. For the other DT (counting dual task), participants had to walk while performing serial subtractions. After inclusion, participants kept a 6-month falls diary. Results: Eighteen (56.3%) of the 32 included patients fell. Ten (31.3%) were single fallers (SFs), and 8 (25%) were multiple fallers (MFs). Fallers (Fs) more frequently used a walking aid and more frequently needed an observatory person for walking safely (FAC score of 3) than nonfallers (NFs). Two gait decrement parameters in counting dual task could distinguish potential Fs from NFs: decrement in stride length percentage (PZ.043) and nonparetic step length percentage (PZ.047). Regarding the division in 3 groups (NFs, SFs, and MFs), only MFs had a significantly higher percentage of decrement for paretic step length (PZ.023) than SFs. Conclusions: Examining the decrement of spatial gait characteristics (stride length and paretic and nonparetic step length) during a DT addressing working memory can identify fall-prone subacute stroke patients.

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supporting

confidence: 53%

Gait Analysis With Cognitive-Motor Dual Tasks to Distinguish Fallers From Nonfallers Among Rehabilitating Stroke Patients

Baetens

Kegel

Palmans

et al. 2013

Archives of Physical Medicine and Rehabilitation

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“…Falling is one of the most common complications of stroke, and stroke patients have a higher risk of falling than elderly (Jorgensen et al 2002). Therefore, a number of studies have focused on fall prevention during inpatient stroke rehabilitation (Andersson et al 2006;Czernuszenko and Czlonkowska 2009). Campbell and Matthews (2010) reported that the falls during inpatient stroke rehabilitation was considered as potential risk factors of impairment of balance and self-care.…”

Section: Discussionmentioning

confidence: 99%

Impaired Dynamic Balance Is Associated with Falling in Post-Stroke Patients

Cho¹,

Lee

2013

Tohoku J. Exp. Med.

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Falling is one of the most common complications of stroke. The purpose of this study was to investigate the impact of falling on cognitive and physical function in post-stroke patients. Further, the predictive factors associated with independence of activity of daily living (ADL) in stroke patients with falls experience were investigated. Sixty-six participants were divided into 2 groups according to history of falling: faller (n = 34) and non-faller (n = 32). All participants were examined for cognitive and physical function. Static balance was measured by postural sway using a force platform. Dynamic balance was measured using the Berg Balance Scale (BBS) and the Modified Rivermead Mobility Index (MRMI), which shows the degree of performance for balance tasks. ADL was measured using the Modified Barthel Index (MBI), which shows the degree of independence. The fallers showed lower cognitive and physical function than the non-fallers (p < 0.05). This finding indicates that falling is associated with reduced physical function, as well as reduced cognitive function. In the fallers, the ADL (MBI) was moderately correlated with each of cognition [MMSE (r = 0.388, p = 0.023)], dynamic balance [MRMI (r = 0.514, p = 0.002) and BBS (r = 0.572, p < 0.000)]. In addition, regression analysis showed that BBS was a primary predictor for ADL performance (R 2 = 0.327, β = 0.572, p < 0.000). Our findings indicate that enhancement of dynamic balance is needed to improve in activities necessary for normal self-care of stroke patients with falls experience.

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“…None had unlimited outdoor mobility (>0.8 m/s). Using 14s as the threshold to indicate a high risk of falls on the TUG test [24]; four participants had a high risk of falls; two of whom reported falling in the last year. None of the stroke survivors scored less than 45 on the BBS, which is a proposed threshold [25] of increased falls risk post-stroke.…”

Section: Participantsmentioning

confidence: 99%