Fall risk in stroke survivors: Effects of stroke plus dementia and reduced motor functional capacity

Whitney, Daniel G.; Dutt-Mazumder, Aviroop; Peterson, Mark D.; Krishnan, Chandramouli

doi:10.1016/j.jns.2019.04.035

Cited by 21 publications

(16 citation statements)

References 47 publications

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“…The balance impairment in the poststroke state is complex. It includes weight-bearing asymmetry (WBA), 1À7 muscle weakness, 8 disturbed perception, 9 destroyed ankle proprioception, 10 cognitive failure 11,12 and in consequence an increased visual dependency. 9,13 All of these factors lead to postural instability and finally to falls.…”

Section: Introductionmentioning

confidence: 99%

Postural instability years after stroke

Halmi

Stone

Dinya

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

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Background: Following a stroke, balance disturbances often persist despite full recovery of the paretic side. Aims: The aims were to determine how long postural instability could be detected after stroke and the differences in post-stroke patients under and above 65 years of age. Methods: Static and dynamic posturography (passing weights from hand to hand around the body) measurements were performed on 29 patients with stroke after 3 § 2.4 years (65 years) and 4.7 § 3.3 years. (> 65 years) compared with 38 controls. Results: Only the pathway and the velocity assessed by dynamic posturography were significantly higher (p < 0.05) in the younger group of patients compared with the controls. The older group of patients had significantly elevated parameters measured by both static (p < 0.01) and dynamic posturography (p < 0.05). Conclusions: we conclude, using a sensitive and reproducible method to assess both static and dynamic adjustments to maintain balance, that postural instability is significantly greater in post-stroke patients than control subjects. This difference is demonstrable up to 4 years after stroke, despite full recovery of the affected side.

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Section: Introductionmentioning

confidence: 99%

Postural instability years after stroke

Halmi

Stone

Dinya

et al. 2020

Journal of Stroke and Cerebrovascular Diseases

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“…Pressure ulcers are the long-term compression of local skin or soft tissues and then a kind of ischemia, hypoxia, or malnutrition ulcer necrosis, and it is one of the common complications of patients with coma, hemiplegia, or postural restriction caused by ICH ( 11 ). Falls are more common in patients with impaired motor and cognitive function and are also an important mechanism of injury leading to ICH ( 12 , 13 ). During the nursing period of this study, the incidence of pressure sores and falls in the study group were significantly lower than that in the control group.…”

Section: Discussionmentioning

confidence: 99%

Clinical Observation of Comfort Nursing Combined With Continuous Nursing Intervention After Discharge on Improving Pressure Ulcers, Falls, Quality of Life, and Prognosis in Patients With Intracerebral Hemorrhage

Liu

Wang

2022

Front. Surg.

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In this prospective study, we randomly divided 131 patients with intracerebral hemorrhage (ICH) who met the inclusion criteria into two groups. One group received routine nursing during hospitalization, and the “Stroke Prevention Knowledge Manual” was issued before discharge, and was recorded as the control group (n = 61); one group received comfort nursing during hospitalization, and implemented continuous nursing after discharge, and was recorded as the research group (n = 70). The indicators we observed were the occurrence of pressure ulcers and falls during the hospitalization of the two groups of patients and the improvement in neurological function, limb function, quality of life, ability of daily living, and emotional state after the intervention. We also compared the disability degree of the two groups 6 months after discharge, the readmission status within 6 months of discharge, and the nursing satisfaction after the intervention. Our conclusion is that comfort nursing combined with continuous nursing intervention after discharge can effectively reduce the occurrence of pressure ulcers and falls during the nursing period of patients with ICH and contribute to the improvement of their quality of life and prognosis. It is worthy of clinical promotion.

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“…Other authors have also found a relationship between functionality and either the risk of falling and/or the occurrence of falls, regardless of the scale used to assess functionality. 33 , 36 – 39 …”

Section: Discussionmentioning

confidence: 99%

Assessing the risk for falls among Portuguese community-dwelling stroke survivors. Are we using the better tools? Observational study

Pimenta

Correia

Alves

et al. 2022

Porto Biomedical Journal

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This study assesses the estimation of the risk for falls among community-dwelling stroke survivors referred for ambulatory physiotherapy and explores factors that affect the risk.Methods: Observational, cross-sectional with nested case-control study, of individuals, referred to physiotherapy less than 12 months after stroke and able to walk independently. Berg Balance Scale, Timed Up and Go Test, and the Motor Assessment Scale were applied. Berg Balance Scale 45 or Timed Up and Go Test >14 were used to estimate the risk for falls. The discrimination ability of the estimation was assessed. Alternative models were explored by logistic regression analysis.Results: One hundred sixty-seven patients fulfilled the inclusion criteria. Patients were 21 to 87 years old (median 66), 98 men (58.7%), and in 133 (79.6%) the stroke occurred in the last 6 months. Falls were reported by 78 (46.7%) of the patients but 139 ) were estimated as having risk for falls. The discrimination ability of the estimation of the actual occurrence of falls by Berg Balance Scale 45 or Timed Up and Go Test >14 was 55% (95%CI 47.5-62.4). The actual occurrence of falls was associated only with Motor Assessment Scale, as a protective factor. The discrimination ability of the estimation of the actual occurrence of falls by Motor Assessment Scale alone was area under the curve 0.69 (95%CI 0.60-0.77).Conclusions: Different tools with better performance are needed to identify the risk for falls after stroke.

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Fall risk in stroke survivors: Effects of stroke plus dementia and reduced motor functional capacity

Cited by 21 publications

References 47 publications

Postural instability years after stroke

Postural instability years after stroke

Clinical Observation of Comfort Nursing Combined With Continuous Nursing Intervention After Discharge on Improving Pressure Ulcers, Falls, Quality of Life, and Prognosis in Patients With Intracerebral Hemorrhage

Assessing the risk for falls among Portuguese community-dwelling stroke survivors. Are we using the better tools? Observational study

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