Risk Factors Associated With Falls in Adult Patients After Stroke Living in the Community: Baseline Data From a Stroke Cohort in Brazil

Pinto, Elen Beatriz; Nascimento, Carla Ferreira do; Marinho, Camila; Oliveira, I. P.; Monteiro, Maiana; Castro, Mayra; Myllane-Fernandes, Paula; Ventura, Lais M.G.B.; Maso, Iara; Lopes, Antônio Alberto; Oliveira‐Filho, Jamary

doi:10.1310/tsr2103-220

Cited by 28 publications

(13 citation statements)

References 42 publications

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“…This could explain why physical impairment aspects still dominate stroke and falls research in this region. The risk and associated factors of falls in this review also illustrated similar findings as with many previous studies (21,155), where physical impairments were the main risk factors for falls after stroke. This over-emphasis on physical rehabilitation is not only exclusive to stroke rehabilitation but also appears in other areas such as in cancer rehabilitation (152).…”

Section: An Over-emphasis On Physical Rehabilitation For Falls Prevensupporting

confidence: 88%

Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders' Consultation

Ainuddin

Romli

Hamid

et al. 2021

Front. Public Health

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Background: Research on rehabilitation for falls after stroke is warranted. However, published evidence on fall interventions with stroke survivors is limited and these are mainly international studies that may be less relevant for Southeast Asia.Objective: This review aims to systematically identify literature related to stroke rehabilitation for falls and risk of falls in Southeast Asia.Methods: A scoping review with stakeholders' consultation was implemented. An electronic search was conducted up to December 2020 on 4 databases (Medline, CINAHL, Scopus, ASEAN Citation Index). Only original studies conducted in Southeast Asia were selected.Results: The initial search yielded 3,112 articles, however, only 26 were selected in the final analysis. Most of the articles focused on physical rehabilitation and implemented conventional therapies. While the literature may reflect practice in Southeast Asia, stakeholders perceived that the literature was inadequate to show true practice, was not informative and missed several aspects such as functional, cognitive, and psychological interventions in managing falls. Individual-centric interventions dominated the review while community-based and environmental-focused studies were limited. Majority of the articles were written by physiotherapists while others were from physicians, occupational therapists, and an engineer but few from other healthcare practitioners (i.e., speech therapists, psychologists) or disciplines interested in falls.Conclusions: Falls prevention among stroke survivors has received a lack of attention and is perceived as an indirect goal in stroke rehabilitation in Southeast Asia. More innovative research adopted from falls research with older people is needed to advance falls prevention and intervention practice with stroke survivors.

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Section: An Over-emphasis On Physical Rehabilitation For Falls Prevensupporting

confidence: 88%

Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders' Consultation

Ainuddin

Romli

Hamid

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

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“…It has been documented that individuals with poor TUGT performance and longer duration since the onset of injury demonstrate particularly high fall rates (Pinto et al, 2014). In the TUGT, individuals with an accomplishment time of less than 10 s have a low risk of falls, 20-29 s an average risk of falls, and more than 30 s a high risk of falls (Barry et al, 2014;Bischoff et al, 2003).…”

Section: Discussionmentioning

confidence: 99%

Interactive Video Gaming Improves Functional Balance in Poststroke Individuals: Meta-Analysis of Randomized Controlled Trials

et al. 2018

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The main objective of this study was to evaluate the effects of interactive video games on functional balance and mobility in poststroke individuals. The Health Science databases accessed included Medline via PubMed, LILACS, SciELO, and PEDro. The inclusion criteria were as follows: clinical studies evaluating the use of interactive video games as a treatment to improve functional balance and mobility in individuals poststroke and studies published in the Brazilian Portuguese, English, or Spanish language between 2005 and April 2016. PEDro Scale was used to analyze the methodological quality of the studies. The Berg Balance Scale and Timed Up and Go Test (TUGT) data were evaluated using a meta-analysis, the publication bias was assessed by funnel plots, and the heterogeneity of the studies by I statistic. Eleven studies were included in the final analysis. Functional balance improved in individuals treated using interactive video games (mean difference = 2.24, 95% confidence interval [0.45, 4.04], p = .01), but no improvement was observed in mobility as measured by TUGT. The studies presented low heterogeneity (24%). The mean score on the PEDro Scale was 6.2 ± 1.9. Interactive video games were effective in improving functional balance but did not influence the mobility of individuals poststroke.

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“…Nevertheless, observational studies on the risks of post-stroke falls are limited. Existing studies examining the risks of post-stroke falls in the community are mostly small and cross-sectional in design [7, 8]. Large prospective studies are few.…”

Section: Introductionmentioning

confidence: 99%

Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study

et al. 2019

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BackgroundStroke patients have increased risks of falls. We examined national registry data to evaluate the association between post-stroke functional level and the risk of low falls among post-stroke patients.MethodsThis retrospective cohort study analyzed data from national registries to examine the risk factors for post-stroke falls. Data for patients who suffered ischemic strokes and survived the index hospital admission was obtained from the Singapore National Stroke Registry and matched to the National Trauma Registry, from 2011 to 2015. The primary outcome measure was a low fall (fall height ≤ 0.5 m). Competing risk analysis was performed to examine the association between functional level (by modified Rankin score [mRS] at discharge) and the risk of subsequent low falls.ResultsIn all, 2255 patients who suffered ischemic strokes had recorded mRS. The mean age was 66.6 years and 58.5% were men. By the end of 2015, 54 (2.39%) had a low fall while 93 (4.12%) died.After adjusting for potential confounders, mRS was associated with fall risk with an inverted U-shaped relationship. Compared to patients with a score of zero, the sub-distribution hazard ratio (SHR) increased to a maximum of 3.42 (95%CI:1.21–9.65, p = 0.020) for patients with a score of 2. The SHR then declined to 2.45 (95%CI:0.85–7.12, p = 0.098), 2.86 (95%CI:0.95–8.61, p = 0.062) and 1.93 (95%CI:0.44–8.52, p = 0.38) for patients with scores of 3, 4 and 5 respectively.ConclusionsAn inverted U-shaped relationship between functional status and fall risk was observed. This is consistent with the complex interplay between decreasing mobility (hence decreased opportunity to fall) and increasing susceptibility to falls. Fall prevention intervention could be targeted accordingly.(263 words)

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Risk Factors Associated With Falls in Adult Patients After Stroke Living in the Community: Baseline Data From a Stroke Cohort in Brazil

Abstract: Patients with poor TUG performance, longer times since stroke onset, and right-hemisphere injury have particularly high fall rates, and TUG cutoff points for fall prediction vary according to cerebral hemisphere.

Cited by 28 publications

References 42 publications

Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders' Consultation

Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review With Stakeholders' Consultation

Interactive Video Gaming Improves Functional Balance in Poststroke Individuals: Meta-Analysis of Randomized Controlled Trials

Post-stroke patients with moderate function have the greatest risk of falls: a National Cohort Study

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