Article

OBJECTIVE: To identify risk factors and predict falling in stroke patients. To
determine the strength of general vs mobility screening for this prediction.
DESIGN: Prospective study. SUBJECTS: Patients in the first 6 months after stroke.
METHODS: The following assessments were carried out: an interview concerning
civil state and fall history, Mini-Mental State Examination, Geriatric Depression
Scale, Falls Efficacy Scale (FES), Star Cancellation Task (SCT), Stroop test,
Berg Balance Scale, Functional Ambulation Categories (FAC), Motricity Index, grip
and quadriceps strength, Modified Ashworth Scale, Katz scale, and a 6-month fall
follow-up. RESULTS: Sixty-five patients were included for analysis. Thirty -eight
(58.5%) reported falling. Risk factors were: being single (odds ratio (OR) 4.7;
95% confidence interval (95% CI) 1.2-18.3), SCT-time (OR 1.2; 95% CI 1.0-1.3),
grip strength on unaffected side (US) (OR 0.1; 95% CI 0.0-0.8), FAC 3 vs FAC 4-5
(OR 8.1; 95% CI 1.5-43.2), and walking aid vs none (OR 5.1; 95% CI 1.4-17.8).
These parameters were included in predictive models, which finally implied a
general model (I) with inclusion of SCT-time, FAC category and use of walking
aid. A mobility model (II) included: FAC category and strength (US). These models
showed a sensitivity of 94.1% and 76.3%, respectively. CONCLUSION: Several
assessments and both prediction models showed acceptable accuracy in identifying
fall-prone patients. A purely physical model can be used; however, looking beyond
mobility aspects adds value. Further validation of these results is required.

Langue : ANGLAIS