Proposal for a New Predictive Scale for Recurrent Risk of Fall in a Cohort of Community-Dwelling Patients with Stroke

Pinto, Elen Beatriz; Nascimento, Carla Ferreira do; Monteiro, Maiana; Castro, Mayra; Maso, Iara; Campos, Adriana Ruano; Marinho, Camila; Barreto-Neto, Nestor; Lopes, Antônio Alberto; Jesus, Pedro Antônio Pereira de; Oliveira‐Filho, Jamary

doi:10.1016/j.jstrokecerebrovasdis.2016.06.045

Cited by 11 publications

(13 citation statements)

References 42 publications

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“…Other studies have been conducted in community-dwelling populations; in a small population, greater stroke severity (NIHSS !4) was shown to be associated with higher fall risk [21], but in another study the opposite was found [10]. In yet another community study, the current NIHSS score was not associated with falls in stroke survivors who walked independently [78]. These results are not directly comparable to our population including both ambulatory and sedentary stroke inpatients in subacute stage.…”

Section: Discussioncontrasting

confidence: 71%

Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures

Tarvonen-Schröder

Niemi

Hurme

et al. 2021

European Journal of Physiotherapy

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Introduction: No single tool is able to distinguish fallers from non-fallers. The aim of this study was to detect subacute stroke inpatients at higher risk for falls, predictors for the number of falls and near falls and the impact of these incidents on functional outcome. Methods: An observational prospective cohort study comparing clinical differences between non-fallers, onetime and repeat fallers. Bivariate and multivariate Poisson regression analyses with length of stay as an offset variable were conducted. Results: Fallers had mostly intermediate level of impairment and disability (NIHSS, FIM, mRS, the ICF minimal generic data set). The onetime fallers who were oldest, most disabled and most often institutionalised achieved the same functional improvement as the non-fallers, however, after significantly longer inpatient rehabilitation. The repeat fallers who were youngest and had the longest rehabilitation in-stay, achieved equal functioning as the non-fallers having faster motor gain and the greatest overall functional improvement compared to the other two subgroups. Conclusions: Right hemispheric stroke, previous myocardial infarction and shorter time from stroke onset were independent predictors for the number of incidents. In the future, larger studies are recommended to investigate fall rate and different severities of incidents, falls and near falls separately.

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Section: Discussioncontrasting

confidence: 71%

Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures

Tarvonen-Schröder

Niemi

Hurme

et al. 2021

European Journal of Physiotherapy

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“…15,31 Our results showed that TUGT had the best ROC over three tests and was significantly associated with any-falls and recurrent-falls, which may be because TUGT not only focuses on one function, but also contains multiple components of balance and mobility related with executive function, thus directly correlating with falls. 32 In addition, we observed "TUGT-" had a moderate predictive ability in screening any-fallers (AUC at 0.610) but a greater efficacy in screening recurrent-fallers (AUC at 0.726), which may be because any-falls over a 12-month period were mostly considered as an accidental event related to environmental factors while recurrent-falls mostly reflected motor disorders, 28 making "TUGT-" toward detecting recurrent-fallers more reliable. This was consistent with our previous finding that TUGT showed strong ability in discriminating recurrent-fallers.…”

Section: Discussionmentioning

confidence: 99%

The Added Value of Combined Timed Up and Go Test, Walking Speed, and Grip Strength on Predicting Recurrent Falls in Chinese Community-dwelling Elderly

Wang¹,

Song²,

Cheng³

et al. 2021

CIA

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To determine whether combined performance-based models could exert better predictive values toward discriminating community-dwelling elderly with high risk of anyfalls or recurrent-falls. Participants and Methods: This prospective cohort study included a total of 875 elderly participants (mean age: 67.10±5.94 years) with 513 females and 362 males, recruited from Hangu suburb area of Tianjin, China. All participants completed comprehensive assessments. Methods: We documented information about sociodemographic information, behavioral characteristics and medical conditions. Three functional tests-timed up and go test (TUGT), walking speed (WS), and grip strength (GS) were used to create combined models. New onsets of any-falls and recurrent-falls were ascertained at one-year follow-up appointment. Results: In total 200 individuals experienced falls over a one-year period, in which 66 individuals belonged to the recurrent-falls group (33%). According to the receiver operating characteristic curve (ROC), the cutoff points of TUGT, WS, and GS toward recurrent-falls were 10.31 s, 0.9467 m/s and 0.3742 kg/kg respectively. We evaluated good performance as "+" while poor performance as "-". After multivariate adjustment, we found "TUGT >10.31 s" showed a strong correlation with both any-falls (adjusted odds ratio (OR)=2.025; 95% confidence interval (CI)=1.425-2.877) and recurrent-falls (adjusted OR=2.150; 95% CI=1.169-3.954). Among combined functional models, "TUGT >10.31 s, GS <0.3742 kg/ kg, WS >0.9467 m/s" showed strongest correlation with both any-falls (adjusted OR=5.499; 95%CI=2.982-10.140) and recurrent-falls (adjusted OR=8.260;. And this combined functional model significantly increased discriminating abilities on screening recurrent-fallers than a single test (C-statistics=0.815, 95%CI=0.782-0.884, P<0.001), while not better than a single test in predicting any-fallers (P=0.083). Conclusion:Elderly people with poor TUGT performance, weaker GS but quicker WS need to be given high priority toward fall prevention strategies for higher risks and frequencies. Meanwhile, the combined "TUGT-, GS-, WS+" model presents increased discriminating ability and could be used as a conventional tool to discriminate recurrent-fallers in clinical practice.

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“…The physiological changes that occur during aging can be accompanied by systemic dysfunctions that interfere with the functional independence of older adults [3]. The latter is fundamental for the execution of basic and instrumental activities of daily living since changes in functional capacities have implications for the prevention and treatment of degenerative diseases that increase with age [4].…”

Section: Introductionmentioning

confidence: 99%

Components of physical fitness as prognostic factors for falls in elderly female exercise practitioners: a longitudinal study

et al. 2020

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Introduction: Physical exercise is used as a strategy for the prevention of falls because it improves the physical fitness of older adults. Objective: To determine which components of physical fitness are predictors of falls in elderly female exercise practitioners. Method: Longitudinal, descriptive, comparative study. The components of physical fitness (upper and lower limb strength and flexibility, agility, aerobic endurance, and hand grip strength) and the occurrence or not of falls in the last 12 months were analyzed in 80 older women practitioners of exercise from 2013 to 2016. Descriptive analysis, ROC curve attributing cut-off points, and binary logistic regression for the prediction of falls were used. Results: The mean age of the participants was 67.46 years (SD=7.65). Over the years, a significant difference between elderly fallers and non-fallers was observed for right hand grip strength (2013 and 2015), left hand grip strength (2014 and 2015), lower limb flexibility (2013, 2014 and 2015), agility (2015), and aerobic endurance (2015). In adjusted analysis, older women with poor lower limb flexibility in 2013 had a higher risk of falls in 2016 (OR=4.98; 95%CI 1.12 - 22.1). Older women with poor flexibility in 2015 also had a higher risk of falls (OR= 6.08; 95%CI 1.06 - 34.67). Conclusion: Poor performance in the lower limb flexibility, right and left hand grip strength, agility and aerobic endurance tests was associated with falls and these components are predictors of future falls in elderly exercise practitioners.

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Proposal for a New Predictive Scale for Recurrent Risk of Fall in a Cohort of Community-Dwelling Patients with Stroke

Cited by 11 publications

References 42 publications

Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures

Fall assessment in subacute inpatient stroke rehabilitation using clinical characteristics and the most preferred stroke severity and outcome measures

The Added Value of Combined Timed Up and Go Test, Walking Speed, and Grip Strength on Predicting Recurrent Falls in Chinese Community-dwelling Elderly

Components of physical fitness as prognostic factors for falls in elderly female exercise practitioners: a longitudinal study

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