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Six‐month prospective study of fall risk factors identification in patients post‐stroke
Author(s) -
Jalayondeja Chutima,
Sullivan Patricia E,
Pichaiyongwongdee Sopa
Publication year - 2014
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/ggi.12164
Subject(s) - medicine , fear of falling , stroke (engine) , physical therapy , odds ratio , confidence interval , berg balance scale , balance (ability) , activities of daily living , falling (accident) , prospective cohort study , fall prevention , physical medicine and rehabilitation , incidence (geometry) , poison control , injury prevention , emergency medicine , psychiatry , mechanical engineering , engineering , physics , optics
Aim To determine if the findings at month 1 could correctly identify stroke patients who fell in the 6 months post‐stroke; and to describe the characteristics of fallers and non‐fallers, and their courses of recovery. Methods Of 133 volunteers who had their first stroke, 98 participants completed the assessment three times. F all incidence and history were collected by telephone every 2 weeks and recorded. Fear of falling measured by the Fall Efficacy Scale ( FES ‐ S ), the amount of time that physical therapy was received, and standardized outcome measures according to the International Classification Functioning, Disability and Health model were measured at month 1, 3 and 6 after stroke. The Berg Balance Scale, Barthel Index, Timed Up & Go, 10‐m (10mWT) and 2‐min walks and participation subscore of Stroke Impact Scale were used for assessment. Results A total of 25 patients (25%) fell in the 6 months; 13 had multiple falls. Fallers showed less improvement in impairments, activity and community participation compared with non‐fallers. The risk of falling was greater than 1 (odds ratio [ OR ]) when assessed by all outcome measures at month 1, and was double at month 3. The FES ‐ S ≥33 at month 1 could accurately identify a faller ( OR 2.99, 95% confidence interval 1.07–8.37), moderate to high sensitivity (76%), specificity (49%), and positive and negative predicted value (34% and 85%). Conclusions Fear of falling was the best indicator of falling. Receiving physical therapy after a stroke seems to highly contribute to improved functional independence of activities in daily living, and increased self‐confidence and cognitive function. Geriatr Gerontol Int 2014; 14: 778–785.