Risk Factors for Falling in Home-Dwelling Older Women With Stroke The Women’s Health and Aging Study

Coventry University, Coventry, England, United Kingdom
Stroke (Impact Factor: 5.72). 03/2003; 34(2):494-501. DOI: 10.1161/01.STR.0000053444.00582.B7
Source: PubMed


Much of our knowledge of risk factors for falls comes from studies of the general population. The aim of this study was to estimate the risk of falling associated with commonly accepted and stroke-specific factors in a home-dwelling stroke population.
This study included an analysis of prospective fall reports in 124 women with confirmed stroke over 1 year. Variables relating to physical and mental health, history of falls, stroke symptoms, self-reported difficulties in activities of daily living, and physical performance tests were collected during home assessments.
Risk factors for falling commonly reported in the general population, including performance tests of balance, incontinence, previous falls, and sedative/hypnotic medications, did not predict falls in multivariate analyses. Frequent balance problems while dressing were the strongest risk factor for falls (odds ratio, 7.0). Residual balance, dizziness, or spinning stroke symptoms were also a strong risk factor for falling (odds ratio, 5.2). Residual motor symptoms were not associated with an increased risk of falling.
Interventions to reduce the frequency of balance problems during complex tasks may play a significant role in reducing falls in stroke. Clinicians should be aware of the increased risk of falling in women with residual balance, dizziness, or spinning stroke symptoms and recognize that risk assessments developed for use in the general population may not be appropriate for stroke patients.

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Available from: Linda P Fried, Mar 08, 2015
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    • "Postural control is the ability to control posture in order to maintain an upright stance during functional activities and to compensate for external and internal body perturbations to avoid falls. Impaired balance was found to be a predictor of falls in community-dwelling older women after stroke [37]. Balance and postural disorders are among the most prevalent consequences, affecting 50% of post-stroke patients in France [12]. "
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    ABSTRACT: After stroke, the causes of balance disorders include motor disorders, sensory loss, perceptual deficits and altered spatial cognition. This review focuses on motor strategies for postural control after stroke. Weight-bearing asymmetry, smaller surface of stability, increased sway, body tilting and sometimes pushing syndrome are observed. Weakness and sensory impairments account only for some of these disturbances; altered postural reactions and anticipated postural adjustments as well as abnormal synergistic muscular activation play an important part. These disorders are often linked to cognitive impairments (visuospatial analysis, perception of verticality, use of sensory information, attention, etc.), which explain the preeminent disorders of postural control seen with right rather than left-hemisphere lesions. Most of the motor changes are due to an impaired central nervous system but some could be considered adaptive behaviors. These changes have consequences for rehabilitation and need further studies for building customized programs based on the motor comportment of a given patient.
    Full-text · Article · Nov 2015 · Neurophysiologie Clinique/Clinical Neurophysiology
    • "Balance disorders occurring after stroke are closely related to the degree of functional level (Tyson et al., 2007). Balance problems are shown as the most important reason of falling in chronic stroke patients (Lamb et al., 2003). Balance is controlled by complex interactions of sensory and motor systems. "
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    ABSTRACT: BACKGROUND: We thought that the application of Kinesio Tape (KT) on the foot and ankle in stroke patients may improve the quality of somatosensory information and may activate ankle muscles which have an important role in postural control and that ultimately balance could be improved in stroke patients. OBJECTIVE: The purpose of this study was to evaluate the effects of KT on balance in stroke patients. METHODS: Nineteen stroke patients and 16 healthy controls were included in the study. The study group was evaluated with and without KT. Balance of the all subjects was evaluated Sensory Organization Tests (SOT) by using the Computerized Dynamic Posturography. Equilibrium, Strategy Analysis and Composite Equilibrium Scores were investigated in SOT. RESULTS: Statistically significant differences were observed in all of the SOT parameters between stroke patients and healthy controls (p < 0.05). When the results with and without KT application were compared, the Equilibrium Scores in the conditions 3, 4, 6, Strategy Analysis Score in the conditions 2, 4, 6 and the Composite Equilibrium Score of the SOT were found to be improved in stroke patents (p < 0.05). CONCLUSIONS: The results obtained from KT application are promising in improving balance in stroke patients.
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    • "Stroke Research and Treatment to be high, ranging between 23–34%, 40–73%, and 43–70% during a 3-4 month [7] [16], 6-month [17] [18], and 1-year follow-up [19] [20], respectively. Most falls are reported to result from a trip, a slip, or a misplaced step while walking [17, 21–24] and walking is also the most frequently reported activity (39%–90%) at the time of a fall in stroke survivors [7] [17] [25] [26], suggesting the reduced ability of individuals with stroke to adjust walking to task and environmental demands. "
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