Clinical analysis of risk factors for falls in home-living stroke patients using functional evaluation tools

Abstract

Objectives: To identify risk factors associated with falls in home-living stroke patients and to predict falls using patient information and functional evaluation tools.

Design: Cohort study.

Setting: Community.

Participants: We recruited 101 home-living stroke patients who had hemiparesis and could walk independently with or without supporting devices. Disease duration ranged from 1 to 22 years (mean, 6.1 y).

Interventions: Not applicable.

Main outcome measures: The score of each item of the Stroke Impairment Assessment Set (SIAS), and the FIM instrument, sex, age, duration of disease, stroke type, affected side of the body, frequency of rehabilitation, use of sedatives, and Mini-Mental State Examination score were evaluated and the occurrence of falls was observed prospectively for 12 months.

Results: Forty-five (44.6%) participants fell, 20 of whom fell repeatedly. A logistic model for predicting falls was refined until it included 4 predictors: memory score on the FIM, range of motion of the lower extremities on the SIAS, duration of disease, and affected side. The predictive value of the logistic model was 86.7%.

Conclusions: Evaluation tools were useful for predicting falls and devising preventive strategies in the high-risk group of home-living stroke patients.