Predicting Falls among Patients after Post-Stroke Discharge Using Physical Function Assessment on Admission

Abstract

The purpose of this study was to estimate the relationship between physical function at hospitalization and falls after discharge. [Subjects] The participants were 79, community-dwelling patients with stroke who had independent gait. [Methods] Physical function was measured by Brunnstrom Recovery Stage, one-leg standing time, and 10-m walking time. Subjects recorded experiences of falls for one year after discharge from rehabilitation. [Results] Sixty-three per cent of people (50/79) had a fall accident in the year after discharge. The fall group showed lower Brunnstrom Recovery Stage, lower one-leg standing, weaker knee extensor strength, lower Barthel Index and higher 10-m walking time than the no-fall group (p<0.05). Logistic regression analysis also indicated that the fall group had lower one-leg standing time than the no-fall group (95% CI: 0.829-0.981). The cutoff value for the one-leg standing time in predicted fall was 3.5 sec (sensitivity 86.0%, specificity 69.0%). [Conclusion] One-leg standing time during hospitalization was associated with falls for one year after discharge from rehabilitation, suggesting that this test is effective at predicting fall accidents for patients with stroke.

Availability of the Two-step Test to evaluate balance in frail people in a day care service

“…Evaluations of balance ability such as the one-leg standing time and the Timed Up and Go (TUG) test are performed in medical facilities to assess the risk of falling 1 , 2 , 3 , 4 , 5 , 6 ) . However, evaluations focused on fall prevention are seldom performed under long-term care insurance or during home-based rehabilitation.…”

Development of an independent ambulation rating chart for post-stroke hemiplegic patients in the recovery stage: at what level is patients free to walk within rehabilitation ward

“…In stroke patients, various factors for falls have been reported, including the ability to perform activities of daily living, status of incontinence, balance ability, severity of motor palsy, status of unilateral spatial neglect, use of diuretics, and use of antidepressant or sedatives [1][2][3]. In addition, a large number of risk assessment tools for falls in post-stroke hemiplegic patients have been developed, such as 10-m walking time [4], lower limb muscle strength evaluation [5], one-leg stance time [5], Berg balance scale (BBS) [6][7][8][9], functional reach test (FR) [10], timed up and go test (TUG) [11], cognitive function evaluations such as dual-task [6,9,12], and higher order brain function evaluations [2,3,13]. In some tools such as the BBS, FR, TUG, and 10-m walking time, cutoff values for independent ambulation have been set.…”