Determinants of Recurrent Falls Poststroke: A 1-Year Follow-up of the Fall Study of Gothenburg.

Abstract:

OBJECTIVE:To identify the occurrence of recurrent falls and the determinants in the acute phase poststroke that are associated with recurrent falls within the first year poststroke. DESIGN:Prospective follow-up study. SETTING:Stroke unit and community. PARTICIPANTS:Patients (N=504) with acute stroke. INTERVENTIONS:Not applicable. MAIN OUTCOME MEASURES:The dependent variable was recurrent falls, defined as ≥2 falls, within the first year poststroke. The independent baseline variables were related to function, activity, participation, personal and environmental factors, and comorbidity and were assessed within 4 days after admission to a stroke unit. Fall data were registered at the stroke unit, and self-reported fall data were collected during follow-up using a standardized questionnaire. Determinants of recurrent falls were identified using univariable and multivariable logistic regression analyses. RESULTS:Within 12 months poststroke, 95 of 348 participants (27%) had experienced recurrent falls. Poor postural control (odds ratio [OR] 5.85; 95% confidence interval [CI], 2.84-12.02; P<.0001), moderate postural control (OR 2.41; 95% CI, 1.21-4.80; P=.012), and using a walking aid in the acute phase (OR 2.51; 95% CI, 1.45-4.36; P=.0010) are statistically significant determinants that are associated with recurrent falls within the first year poststroke. The determinant of using a walking aid appears to be primarily driven by those younger than 80 years. In addition to impaired postural control and using a walking aid, a fall at the stroke unit is a determinant associated with recurrent falls after discharge within 6 months poststroke. CONCLUSIONS:More than 1 in 4 individuals with stroke experienced recurrent falls within the first year poststroke. Impaired postural control, using a walking aid in the acute phase, and fall during hospitalization are determinants associated with recurrent falls during follow-up. The determinants differ somewhat at different ages.

journal_name

Arch Phys Med Rehabil

authors

Samuelsson CM,Hansson PO,Persson CU

doi

10.1016/j.apmr.2020.05.010

subject

Has Abstract

pub_date

2020-09-01 00:00:00

pages

1541-1548

issue

9

eissn

0003-9993

issn

1532-821X

pii

S0003-9993(20)30310-5

journal_volume

101

pub_type

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