Six-month prospective study of fall risk factors identification in patients post-stroke

Abstract

© 2014 Japan Geriatrics Society. Aim: To determine if the findings at month1 could correctly identify stroke patients who fell in the 6months 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. Fall incidence and history were collected by telephone every 2weeks 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 month1, 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 6months; 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 month1, and was double at month3. The FES-S ≥33 at month1 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.