Abstract
Teasell R, McRae M, Foley N, Bhardwaj A. The incidence and consequences of falls in
stroke patients during inpatient rehabilitation: factors associated with high risk.
Arch Phys Med Rehabil 2002;83:329-33. Objectives: To determine the incidence of falls on a stroke rehabilitation unit; to assess the
frequency and nature of injuries; and to identify risk factors predictive of falls,
functional outcomes, and impairments. Design: Retrospective cohort study. Setting: An inpatient stroke rehabilitation unit. Participants: Two hundred thirty-eight consecutive stroke patient admissions. Interventions: Incident reports completed on patients who experienced a fall while on the unit were
reviewed and resultant injuries categorized (abrasions, lacerations, fractures). Main Outcome Measures: Stroke impairments and admission functional assessments, FIM™ instrument, Berg Balance
Scale (BBS), and Chedoke-McMaster (CM) Stroke Impairment Inventory of fallers were
compared with nonfallers. Results: Of the 238 patients, 88 (37%) experienced at least 1 fall, and almost half of these
(45 patients [19%]) experienced at least 2 falls. A total of 180 falls were reported
over the 5-year period. Of the 180 reported falls, 33% occurred when patients were
using their wheelchairs. Injuries occurred in 22% of the reported falls. These consisted
of contusions (49%) and abrasions (41%), primarily of the upper (30.8%) and lower
(25.6%) extremities. Only 1 fracture was reported. Fallers tended to have lower admission
BBS scores (50% of patients with a score <30 fell vs 18% with a score >30, P <.01) and a lower score on the admission arm, leg, and foot components of the CM
(P <.05). Patients who fell were also more likely to be apraxic (P <.014) and suffer from cognitive deficits (P <.01). Repeat fallers had lower admission FIM scores (P <.01) when compared with nonfallers. Conclusion: Although patients undergoing stroke rehabilitation experienced a significant number
of falls, the incidence of serious injury was small. Patients who experienced at least
1 fall had significantly lower BBS, FIM, and CM arm, leg, and foot scores compared
with nonfallers. These data suggest that groups of stroke patients who are at risk
for falls within the rehabilitation setting can be identified by using a variety of
impairment and functional assessments. This information may be potentially useful
for designing interventions directed at reducing fall frequency among stroke survivors.
© 2002 by the American Congress of Rehabilitation Medicine and the American Academy
of Physical Medicine and Rehabilitation
Keywords
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Article info
Publication history
Accepted:
April 9,
2001
Received in revised form:
April 9,
2001
Footnotes
☆Supported by the University of Western Ontario Physical Medicine and Rehabilitation Research Fund.
☆☆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.
★Reprint requests to Robert Teasell, MD, 339 Windermere Rd, London, Ont N6A 5A5, Canada, e-mail: [email protected]
★★Supplier
♢a. SPSS Inc, 233 S Wacker Dr, 11th Fl, Chicago, IL 60606.
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Copyright
© 2002 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.
