Using the Imagined Timed Up and Go Test to Identify Fall Risk over the 6-Month Period after Discharge in Patients with Stroke

Abstract

Objective : To determine whether or not the time difference index of the Timed Up and Go test TUG and the imagined TUG iTUG , which reflects motor imagery capacity, has utility in predicting falls in patients with stroke. Method : A follow-up study of falls occurring over the 6-month period after discharge was performed in 47 patients with stroke. Baseline values were evaluated at discharge for subject age, sex, disease name, paralysis side, disease duration, fall history, whether a gait assistive device was used, mini-mental state examination MMSE , TUG, and the time difference delta time between TUG and iTUG. A logistic regression analysis was performed using the number of falls and evaluation results, and the predictive factors for falls were extracted. Results : Thirty-three patients were followed for the entire 6-month period, and the fall rate was 48.5According to the results of the analysis, only delta time was a significant fall factor p 0.01 , and the cutoff value for fall prediction was 0.88 . Conclusion : Our results show that delta time could be used to identify the likelihood of a fall occurrence over the 6-month period after discharge in patients with stroke. Jpn J Rehabil Med .

Cross-Sectional Analysis of Fall-Related Factors with a Focus on Fall Prevention Self-Efficacy and Self-Cognition of Physical Performance among Community-Dwelling Older Adults

“…In a study by Nakano et al [ 22 ], a decrease in motor imagery ability was associated with a higher incidence of falls in older adults using long-term care insurance services. Haruyama et al [ 27 ] also studied community-dwelling stroke patients after discharge from a rehabilitation hospital using TUG and reported that overestimation of TUG speed was a significant predictor of falls six months after discharge. In this study, the cognition error values for the fall group were 0.6 ± 0.21 for TUG at normal speed and 0.55 ± 0.27 for TUG at maximum rapid speed ( Table 2 ), both of which indicated that the timed cognition errors were large and overestimated.…”

“…This difference may have resulted from differences in the demographics of the subjects, as previous studies with younger or healthy older adults included many underestimators, whereas this study included older adults who were already living their daily lives with some disability. Therefore, it can be inferred that the participants in this study included some who were unable to recall their current accurate performance due to their disability or who did not have an updated image of their performance when they were more mobile before their disability when making predictions for each performance [ 22 , 27 ]. Furthermore, both the fall and non-fall groups in this study may be at similar risk, and even if they have not fallen, their spatial cognition and motor imagery abilities are impaired, and these impairments may represent a future fall risk.…”

“…Some reports have suggested that the association between the deviation in self-cognition and the occurrence of falls may be due to the inability to properly visualize the movement due to the reduced function of the simulation mechanism in the brain [ 25 , 26 ]. The fall group was more likely to have discrepancies between self-cognition and actual results regarding the height of the stepping over test and the time required for the gait test [ 26 , 27 ]. It is noteworthy, however, that these previous studies differ in their views on fall prevention self-efficacy and deviations in self-cognitions, which are considered to be fall risk factors.…”