The Association of Balance Capacity and Falls Self-Efficacy With History of Falling in Community-Dwelling People With Chronic Stroke

Abstract 

Belgen B, Beninato M, Sullivan PE, Narielwalla K. The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke.

Objectives

To describe the frequency of falls; to relate capacity-based and self-efficacy measures to fall history; and to determine to what extent capacity-based and self-efficacy measures are explained by subject characteristics and stroke impairments.

Design

Cross-sectional.

Setting

Community.

Participants

Convenience sample of 50 people with chronic stroke.

Interventions

Not applicable.

Main Outcome Measures

Fall history, Falls Efficacy Scale–Swedish Version, fear of falling, and the mood subscore of the Stroke Impact Scale. Balance, strength, and functional mobility were measured using the Berg Balance Scale, timed sit to stand, and Timed Up & Go, respectively.

Results

Falls were reported by 40% (n=20) of subjects; 22% (n=11) reported multiple falls. Subjects with fall history had more fear of falling (relative risk [RR], 2.4; 95% confidence interval [CI], 1.1−4.9), had less falls-related self-efficacy (P=.04), and more depressive symptoms (P=.02) than nonfallers. Subjects with multiple fall history had poorer balance (P=.02), more fear of falling (RR=5.6; 95% CI, 1.3−23), and used a greater number of medications (P=.04) than non- and 1-time fallers. Strength partially explained balance, mobility, and falls-related self-efficacy.

Conclusions

Balance and falls-related self-efficacy are associated with fall history and should be addressed in people with chronic stroke.

Key Words:  Accidental falls , Balance , Cerebrovascular accident , Rehabilitation , Self efficacy