Abstract

OBJECTIVE
To determine predictors of falls in stroke patients in the first 6 months after a baseline evaluation before their discharge from inpatient rehabilitation.
DESIGN
Prospective cohort study.
SETTING
Rehabilitation hospital, then home.
PARTICIPANTS
Consecutive stroke patients (N=66) were followed at home after discharge from the rehabilitation hospital.
INTERVENTIONS
Not applicable.
MAIN OUTCOME MEASURES
Fall occurrence within 6 months after a baseline evaluation. All patients were assessed for baseline data during their inpatient rehabilitation (1.5±1.2 wk before discharge). Data regarding cerebrovascular accident (CVA) date, number of attacks, and brain imaging results were obtained; motor function and balance impairment were examined by the Fugl-Meyer Assessment Scale. The FIM and Functional Ambulation Category were also used. Presence of urinary incontinence, drug use, fall history, postural hypotension, neglect, cognitive status, poor vision, and hearing were evaluated. Six months after the baseline evaluation, any fall occurrence was ascertained via telephone calls to the caregivers of each patient. Multivariate logistic regression analysis was used to identify risk factors.
RESULTS
The mean age ± SD was 64±10 years. The median time elapsed since CVA at the time of admission was 4 months. Twenty-four (36%) patients fell within the 6-month period. The fall rate was significantly higher in patients with left (47%) versus right (21%) hemispheric stroke. Left hemispheric lesion (vs right) showed a 4 times greater risk of fall within 6 months (odds ratio=4.093; 95% confidence interval, 1.082-15.482). There were no other significant differences between fallers and nonfallers with respect to the other evaluated factors.
CONCLUSIONS
Our results suggest that the fall risk within 6 months after a baseline evaluation is greater in patients with left hemispheric lesions versus those with right hemispheric lesions.

Links

Publisher Full Text

Authors

Alemdaroğlu E, Uçan H, Topçuoğlu AM, Sivas F

Institution

Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara, Turkey. ealemdaroglu@gmail.com

Source

Archives of physical medicine and rehabilitation 93:12 2012 Dec pg 2244-50

MeSH

Accidental Falls
Age Factors
Aged
Disability Evaluation
Female
Humans
Male
Middle Aged
Physical Therapy Modalities
Prognosis
Prospective Studies
Rehabilitation Centers
Residence Characteristics
Risk Factors
Sex
Stroke

Pub Type(s)

Journal Article

Language

eng

PubMed ID

22743411