Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 12 , Pages 1601-1605, December 2007

Clinical Analysis of Risk Factors for Falls in Home-Living Stroke Patients Using Functional Evaluation Tools

  • Naoki Wada, MD

      Affiliations

    • Division of Rehabilitation Medicine, Gunma University Hospital, Gunma, Japan
    • Corresponding Author InformationReprint requests to Naoki Wada, MD, Div of Rehabilitation Medicine, Gunma University Hospital, 3-39-15 Showa, Maebashi, Gunma 371-8511, Japan
    • ,
  • Makoto Sohmiya, MD

      Affiliations

    • Division of Rehabilitation Medicine, Gunma University Hospital, Gunma, Japan
    • ,
  • Toru Shimizu, MD

      Affiliations

    • Division of Rehabilitation Medicine, Gunma University Hospital, Gunma, Japan
    • ,
  • Koichi Okamoto, MD

      Affiliations

    • Department of Neurology, Gunma University Graduate School of Medicine, Gunma, Japan.
    • ,
  • Kenji Shirakura, MD

      Affiliations

    • Division of Rehabilitation Medicine, Gunma University Hospital, Gunma, Japan

Abstract 

Wada N, Sohmiya M, Shimizu T, Okamoto K, Shirakura K. Clinical analysis of risk factors for falls in home-living stroke patients using functional evaluation tools.

Objectives

To identify risk factors associated with falls in home-living stroke patients and to predict falls using patient information and functional evaluation tools.

Design

Cohort study.

Setting

Community.

Participants

We recruited 101 home-living stroke patients who had hemiparesis and could walk independently with or without supporting devices. Disease duration ranged from 1 to 22 years (mean, 6.1y).

Interventions

Not applicable.

Main Outcome Measures

The score of each item of the Stroke Impairment Assessment Set (SIAS), and the FIM instrument, sex, age, duration of disease, stroke type, affected side of the body, frequency of rehabilitation, use of sedatives, and Mini-Mental State Examination score were evaluated and the occurrence of falls was observed prospectively for 12 months.

Results

Forty-five (44.6%) participants fell, 20 of whom fell repeatedly. A logistic model for predicting falls was refined until it included 4 predictors: memory score on the FIM, range of motion of the lower extremities on the SIAS, duration of disease, and affected side. The predictive value of the logistic model was 86.7%.

Conclusions

Evaluation tools were useful for predicting falls and devising preventive strategies in the high-risk group of home-living stroke patients.

Key Words: Accidental falls, Rehabilitation, Risk factors, Stroke

 

 No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.

PII: S0003-9993(07)01555-9

doi:10.1016/j.apmr.2007.09.005

Archives of Physical Medicine and Rehabilitation
Volume 88, Issue 12 , Pages 1601-1605, December 2007

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