Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke

Goljar, Nika; Globokar, Daniel; Puzić, Nataša; Kopitar, Natalija; Vrabič, Maja; Ivanovski, Matic; Vidmar, Gaj

doi:10.3109/09638288.2015.1107771

Cited by 18 publications

(17 citation statements)

References 31 publications

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“…In our multivariable analysis, no association was found between age and risk of falling. This is consistent with previous reports based on inpatient rehabilitation after stroke 6,29 and during follow-up after discharge. 13 However, it contradicts another inpatient study 12 in which fallers were younger and a community-based study 5 in which older age was an independent risk factor for falls.…”

Section: Discussionsupporting

confidence: 93%

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Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT)

et al. 2017

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Section: Discussionsupporting

confidence: 93%

“…Our finding is consistent with a study by Nyström and Hellstrom 4 that reported men fell marginally more often than women, while an opposite relationship was reported by Andersson et al 13 Previous studies of later inpatient rehabilitation after stroke found that sex was not associated with the risk of falling. 29…”

Section: Discussionmentioning

confidence: 99%

Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT)

et al. 2017

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“…Falls and their resulting injuries during hospitalization cause serious problems and consequences for patient outcomes, quality of life and increased healthcare costs (7,8). Falls may result in physical injuries including fractures, brain damage, bruising, bleeding and even death (9,10).…”

Section: Introductionmentioning

confidence: 99%

Risk Factors and Characteristics of Falls Among Hospitalized Stroke Patients

Djurovic

Radovanovic

Djonovic

et al. 2021

Serbian Journal of Experimental and Clinical Research

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Falls and fall-related injuries during hospitalization may cause serious problems and consequences for patients, their quality of life as well as increased healthcare expenses. The aim of the paper were to assess fall risks and identify risk factors, related to falls among stroke patients. This was a retrospective cohort study that included 217 neurological patients with acute stroke who have experienced fall during hospitalization. Morse Fall Scale was used to estimate a likelihood of falling for hospitalized patients. In total, 1.4% patients with acute stroke experienced a fall during hospitalization. According to the fall risk assessment, 77% of the patients presented a high risk for falls. Women, older respondents and those who were hospitalized for period longer than 22 days and who had higher levels of care, had higher values of Morse score. The most common risk factors for falls are: the presence of other medical diagnosis, the use of disability aids while walking, the use of intravenous therapy, disorientation in time and space, and the largest contribution to Morse score comes from using disability aids while walking and transferring patients. Greater risk of falling was observed in older neurological patients with ischemic type of stroke and weakness on the left side of the body, patients with longer hospitalization period and those with higher level of care.

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“…Falls are common in stroke survivors, with reported incidences between 26% to 73% within 6‐12 months after discharge from hospital 1‐3 and 23% to 48% of community dwelling older people who fall within a 1‐year period after acute hospitalization 3‐6 . Falls on inpatient stroke rehabilitation units are also common, 5‐9 with 15% to 37% of patients experiencing a fall during their inpatient stay 10,11 …”

Section: Introductionmentioning

confidence: 99%

“…Factors that identify stroke inpatients at risk for falls may include male gender, 20 fear of falling, 21,22 dependence for ADLs, 6,10,23 urinary incontinence, 24,25 impaired balance, 15,19,23,26,27 visuospatial neglect, 10 aphasia, polypharmacy (antihypertensive medications, diuretics, antidepressants, sedatives), 10,28 prior fall, 18,19 and cognitive disorders 8,11,14,15,23,27‐32 . A few studies have reported fall risk in relation to hemispheric side of the stroke, though the results have been inconsistent: some reported that right side stroke had more falls, 33‐35 whereas others reported risk of falling was greater in patients with left hemispheric lesions 9,10,36 …”

Section: Introductionmentioning

confidence: 99%

Predicting Falls Using the Stroke Assessment of Fall Risk Tool

Yang

Ghaedi

Campbell

et al. 2020

PM&R

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Background Falls in the inpatient stroke population are common, resulting in increased morbidity and slow rehabilitation progress. Falls may result from stroke‐specific neurologic deficits; however, assessment of these deficits is lacking in many fall screening tools. Objective To compare the ability to predict falls of the Stroke Assessment of Fall Risk (SAFR) tool, which includes items related to stroke‐specific neurologic deficits, and the commonly used Morse Fall Scale, which does not include these items. Design Prospective cohort study. Setting Inpatient tertiary stroke rehabilitation unit. Participants Patients (N = 220) with acute stroke. Main Outcome Measures Falls were captured by the medical records from January 2017 to September 2018. Logistic regression analysis evaluated both screening tools for predicting falls by calculating sensitivity, specificity, area under the receiver operating characteristic (AUC‐ROC) curve, and odds ratio (OR). We compared SAFR and Morse mean scores between fallers and non‐fallers using t‐tests. Results Forty‐eight (21.8%) patients experienced ≥1 fall. SAFR, but not Morse, scores showed a statistically significant difference between fallers and non‐fallers (P = .001 vs P = .24, respectively). Higher SAFR score was associated with higher odds of falls (OR 1.36, 95% CI [1.12, 1.64]), whereas Morse was not (OR 1.04, 95% CI [0.97, 1.12]). SAFR showed a statistically significant difference in hemi‐neglect between fallers and non‐fallers (P = .03). Sensitivity and specificity of SAFR were 47.9% and 76.7%, vs 45.8% and 68.0% for Morse, respectively. SAFR positive predictive value and negative predictive value were 36.5% and 84.1%, respectively, similar to Morse (28.6% and 81.8%). The AUC‐ROC was 0.65 for SAFR and 0.56 for Morse. Conclusions SAFR was significantly associated with fall risk and had better discrimination between fallers and non‐fallers than Morse. The neurologic‐specific hemi‐neglect component of SAFR, a component not present on the Morse, was a fall risk factor. Further research evaluating the predictive value of fall scales that include neurologic deficits is needed.

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Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke

Cited by 18 publications

References 31 publications

Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT)

Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT)

Risk Factors and Characteristics of Falls Among Hospitalized Stroke Patients

Predicting Falls Using the Stroke Assessment of Fall Risk Tool

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