Abstract
Objective
To identify the occurrence of recurrent falls and the determinants in the acute phase
poststroke that are associated with recurrent falls within the first year poststroke.
Design
Prospective follow-up study.
Setting
Stroke unit and community.
Participants
Patients (N=504) with acute stroke.
Interventions
Not applicable.
Main Outcome Measures
The dependent variable was recurrent falls, defined as ≥2 falls, within the first
year poststroke. The independent baseline variables were related to function, activity,
participation, personal and environmental factors, and comorbidity and were assessed
within 4 days after admission to a stroke unit. Fall data were registered at the stroke
unit, and self-reported fall data were collected during follow-up using a standardized
questionnaire. Determinants of recurrent falls were identified using univariable and
multivariable logistic regression analyses.
Results
Within 12 months poststroke, 95 of 348 participants (27%) had experienced recurrent
falls. Poor postural control (odds ratio [OR] 5.85; 95% confidence interval [CI],
2.84-12.02; P<.0001), moderate postural control (OR 2.41; 95% CI, 1.21-4.80; P=.012), and using a walking aid in the acute phase (OR 2.51; 95% CI, 1.45-4.36; P=.0010) are statistically significant determinants that are associated with recurrent
falls within the first year poststroke. The determinant of using a walking aid appears
to be primarily driven by those younger than 80 years. In addition to impaired postural
control and using a walking aid, a fall at the stroke unit is a determinant associated
with recurrent falls after discharge within 6 months poststroke.
Conclusions
More than 1 in 4 individuals with stroke experienced recurrent falls within the first
year poststroke. Impaired postural control, using a walking aid in the acute phase,
and fall during hospitalization are determinants associated with recurrent falls during
follow-up. The determinants differ somewhat at different ages.
Keywords
List of abbreviations:
95% CI (95% confidence interval), BBS (Berg Balance Scale), FallsGOT (Fall Study of Gothenburg), IQR (interquartile range), OR (odds ratio), SwePASS (Swedish modified version of Postural Assessment Scale for Stroke Patients)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: June 01, 2020
Footnotes
Clinical Trial Registration No.: NCT02264470.
Supported by the Swedish Stroke Association (2018-11-23), the Local Research and Development Board for Gothenburg and South Bohuslän VGFOUGSB-869111 (2018-12-04), the Neuro Foundation F2018-0077 (2018-12-13), and Renée Eander’s Foundation (2018-10-21).
Disclosures: none.
Identification
Copyright
© 2020 by the American Congress of Rehabilitation Medicine
