4.6 Article

Fall events among people with stroke living in the community: Circumstances of falls and characteristics of fallers

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W B SAUNDERS CO-ELSEVIER INC
DOI: 10.1053/apmr.2002.28030

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accidental falls; activities of daily livings; cerebrovascular accident; rehabilitation

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Objectives: To describe the frequency and circumstances of falls among a community sample of people with stroke and to compare characteristics of fallers and nonfallers. Design: Cross-sectional, observational study. Setting: Community. Participants: Forty-one community-dwelling people with stroke (26 men, 15 women; mean age, 69.7 +/- 11.6y), of which. 23 had right-hemi sphere infarction, 16 left-hemisphere infraction, and 2 had a brainstem lesion. Time since onset of stroke ranged from 3 to 288 months (mean, 50mo). Interventions: Not applicable. Main Outcome Measures: Standardized tests were used to measure mobility, upper limb function, activities of daily living (ADL ability), and mood. Information about fall events was collected by using a questionnaire. Results: Twenty-one participants (50%) were classed as fallers. of whom 10 had fallen repeatedly. No significant differences were found between fallers and nonfallers on any of the measures used. However, those who had 2 or more falls (n = 10) had significantly reduced arm function (P = .018) and ADL ability (P = .010), compared with those who had not fallen or experienced near falls (n = 5). Loss of balance, misjudgment, and foot dragging during walking, turning, and sit to stand were reported by fallers as the suspected causes and activities leading to falls. Conclusions: The high risk of falling among people with stroke was evident in this community-based sample. Repeat fallers had greater mobility deficits and significantly reduced arm function and ADL ability than those who did not report any instability.

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