Falls are Associated with Lower Self-reported Functional Status in Patients after Stroke

Publication date: Available online 3 June 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Eline van der Kooi, Sven Kersten Schiemanck, Frans Nollet, Gert Kwakkel, Jan-Willem Meijer, Ingrid Gerrie Lambert van de Port
ObjectiveTo evaluate the association between falls and functional status after stroke.DesignSecondary analysis of data from the randomised, controlled FIT-Stroke trial. Outcomes were measured at the time of discharge from inpatient rehabilitation (T0) and after 12 weeks (T1). Between T0 and T1, all patients attended an outpatient rehabilitation program that included the FIT-Stroke intervention.SettingNine Dutch centres for rehabilitation medicine.ParticipantsOutpatients after stroke with mild cognitive impairments (Mini-Mental State Examination [MMSE] ≥ 24), discharged home after inpatient rehabilitation and able to walk 10 meters independently.InterventionsNot applicable.Main Outcome MeasuresThe primary outcome was the change in Stroke Impact Scale (SIS)-16 score. The independent variable was one or more falls after stroke. The outcome was corrected for type of outpatient rehabilitation (group allocation), severity of hemiplegia (Motricity Index; MI), and cognition (MMSE) at baseline using multiple regression analysis.ResultsThe study included 250 patients after stroke. Complete data were available for 199 patients with a mean age of 58 years (SD 10), MMSE of 28.1 (SD 2), and MI of 130 (SD 43). Fifty-five patients (28%) reported falls during the 12 weeks after discharge from inpatient rehabilitation. Falls were significantly associated with less improvement in functional status as assessed with the SIS-16 (p=0.009).ConclusionAlmost 30% of this stroke population with minor cognitive deficits and moderate to high mobility scores reported falls during the 12 weeks of outpatient rehabilitation. Falls were negatively associated with self-reported functional status measured by the change in SIS-16 score. Therefore, it is important to identify patients with high risk of falls and implement strategies to reduce falls.



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