The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation

Wong, Joseph; Brooks, Dina; Inness, Elizabeth L.; Mansfield, Avril

doi:10.1016/j.jstrokecerebrovasdis.2016.03.017

Cited by 16 publications

(17 citation statements)

References 52 publications

(55 reference statements)

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“…31 The result for cognition assessed using the MoCA is consistent with previous research. 15 Somewhat surprisingly, stroke severity measured with the NIHSS was not associated with the risk of falling. This lack of association has also been found previously.…”

Section: Discussionmentioning

confidence: 98%

“…One predictor of future falls after a stroke is a fall during hospitalization. 4,11 Other known predictors of falling after a stroke are impaired postural control, 13–15 impaired motor function, 13–15 cognitive dysfunction, 16 fear of falling, 17 depression, 18 and decreased ADL. 19 However, few studies have investigated whether factors assessed during 2,5,8,20 or involving 3,7 the acute phase after a stroke are able to predict falls after a stroke.…”

Section: Introductionmentioning

confidence: 99%

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Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT)

2018

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Objective: To identify the incidence of falls and factors present shortly after stroke, which are associated with the occurrence of falls over the first 12 months after stroke onset, following discharge from inpatient rehabilitation. Design: Prospective follow-up study. Setting: Stroke unit and outpatient department. Subjects: A total of 490 individuals with acute stroke. Methods: Postural control was assessed using the Swedish modified version of the Postural Assessment Scale for Stroke Patients. Data on self-reported falls were collected using a standardized questionnaire at three months after discharge and six and 12 months after stroke onset. Associations between characteristics during the acute phase after a stroke and falls after six and 12 months were investigated using univariable and multivariable regression analyses. Main measures: The endpoint was a self-reported fall. Results: Within three months after discharge, 38 of 165 respondents (23%) had experienced at least one fall. Within six and 12 months after stroke onset, respectively, 108 of 376 (29%) and 140 of 348 (40%) of the respondents had experienced at least one fall. Poor postural control (odds ratio 3.92, 95% confidence interval 2.07–7.45, P < 0.0001) and using a walking aid (odds ratio 2.84, 95% confidence interval 1.71–4.72, P < 0.0001) were predictors of falls after discharge within 12 months after stroke onset. The same variables were independent predictors of falls within six months. Conclusion: Poor postural control and using a walking aid in the acute phase after a stroke are associated with falls after discharge from a stroke unit within 12 months after stroke onset.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT)

2018

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“…The body of literature surrounding falls risk in individuals with stroke has generally established that impairments in clinical measures of balance and gait [17,32], as well as specific features of balance and gait [12], constitute risk factors for falls in this population. From retrospective analysis, community-dwelling individuals with stroke and low balance confidence were more likely to have experienced multiple falls than those with higher balance confidence [4].…”

Section: Discussionmentioning

confidence: 99%

“…This study involved cross-sectional, retrospective review of data from individuals with stroke who underwent in-patient stroke rehabilitation at a rehabilitation hospital between September 2010 and March 2013 [12,17]. As part of the larger study, participants were invited to complete a clinical assessment of balance and gait at 6 months post-discharge from in-patient rehabilitation if they had completed the same assessment at discharge from in-patient rehabilitation; had been discharged home from in-patient rehabilitation; and were capable of independent ambulation at discharge [12].…”

Section: Participantsmentioning

confidence: 99%

Balance Confidence Is Related to Features of Balance and Gait in Individuals with Chronic Stroke

Schinkel-Ivy

Wong

Mansfield

2017

Journal of Stroke and Cerebrovascular Diseases

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Reduced balance confidence is associated with impairments in features of balance and gait in individuals with sub-acute stroke. However, an understanding of these relationships in individuals at the chronic stage of stroke recovery is lacking. This study aimed to quantify relationships between balance confidence and specific features of balance and gait in individuals with chronic stroke. Participants completed a balance confidence questionnaire and clinical balance assessment (quiet standing, walking, and reactive stepping) at 6 months post-discharge from inpatient stroke rehabilitation. Regression analyses were performed using balance confidence as a predictor variable and quiet standing, walking, and reactive stepping outcome measures as the dependent variables. Walking velocity was positively correlated with balance confidence, while medio-lateral centre of pressure excursion (quiet standing) and double support time, step width variability, and step time variability (walking) were negatively correlated with balance confidence. This study provides insight into the relationships between balance confidence and balance and gait measures in individuals with chronic stroke, suggesting that individuals with low balance confidence exhibited impaired control of quiet standing as well as walking characteristics associated with cautious gait strategies. Future work should identify the direction of these relationships to inform community-based stroke rehabilitation programs for individuals with chronic stroke, and determine the potential utility of incorporating interventions to improve balance confidence into these programs.

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“…Stroke survivors often have impaired limb control and an impaired ability to maintain balance, which make them more unstable than people with similarly asymmetrical postures. [ 8 , 9 ] Initial balance dysfunction predicts functional recovery after stroke, so balance training is an important aspect of stroke rehabilitation. [ 10 ] The ability to maintain balance has a large influence on the ability to walk, and trunk balance in particular is a determinant of motor function in stroke patients.…”

Section: Introductionmentioning

confidence: 99%

Effects of Tai Chi Yunshou on upper limb function and balance in stroke survivors

et al. 2020

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Background: Functional disability is the most common disorder that occurs after stroke and seriously affects the quality of life of stroke survivors. Tai Chi Yunshou (TCY), a fundamental form of Tai Chi, is a simple, convenient, and economical exercise therapy from ancient China. Some clinical trials have reported that it improves upper limb function and balance during stroke rehabilitation. Thus, we plan to conduct a systematic review to investigate the effects of TCY in stroke survivors. Methods: This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. We will search English and Chinese databases for randomized controlled trials on TCY for stroke survivors from the dates when the databases were established to 1 July 2020. The English databases will include MEDLINE (PubMed), EMBASE (embase.com), and the Cochrane Central Register of Controlled Trials (Cochrane Library). In addition, the Chinese databases will include the Chinese National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the Chinese Science and Technology Periodical Database, the Wanfang database, and the Chinese Dissertation Database. The primary outcomes will include upper limb function and balance function, as measured by the Fugl-Meyer assessment and Berg balance scale, respectively. Two reviewers will independently screen the studies on the basis of the inclusion criteria and extract data. Review Manager (v5.3) will be used for data synthesis, and Cochrane Collaboration's tool will be used to assess the risk of bias. A fixed effects model or a random effects model will be selected based on the level of heterogeneity. The grading of recommendations assessment, development, and evaluation system will be used to evaluate the quality of the outcomes. Results: This systematic review results will be carried out after the completion of the protocol. Conclusions: This protocol aims to guide a systematic review and meta-analysis investigating the effects of JCY on upper limb function and body balance in stroke survivors, which will provide evidence for post-stroke rehabilitation training. PROSPERO registration number: CRD42020169549.

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The Impact of Falls on Motor and Cognitive Recovery after Discharge from In-Patient Stroke Rehabilitation

Cited by 16 publications

References 52 publications

Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT)

Early prediction of falls after stroke: a 12-month follow-up of 490 patients in The Fall Study of Gothenburg (FallsGOT)

Balance Confidence Is Related to Features of Balance and Gait in Individuals with Chronic Stroke

Effects of Tai Chi Yunshou on upper limb function and balance in stroke survivors

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