Brief composite mobility index predicts post-stroke fallers after hospital discharge.
Prudence Plummer, Jody A Feld, Vicki S Mercer and 1 others
PMID 36275923WHAT IT FOUND
A brief discharge score using obstacle crossing, unsupported step test, gait speed, and walking disability predicted 3-month falls after stroke better than obstacle crossing alone.
It was proof-of-concept, not a treatment.
Key findings
01All composite index versions predicted fall status significantly better than the obstacle-crossing test alone.
02Index C had sensitivity 86% and specificity 67% at a cut-off of 6.5 points or higher.
03In external validation, Index D3 predicted fall status, but the original cut-off of 3.5 points or higher gave poor sensitivity.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a proof-of-concept secondary analysis, not a trial of the index in routine care. The derivation sample was small, with 45 participants, and the external validation sample had 30 participants. The optimal cut-off score for the simpler index changed in validation, so the scoring rule is not final. Index C had lower specificity, and several non-fallers were classified as high risk. The study did not measure reactive balance, sensation, proprioception, medications, activity level, fear of falling, or post-discharge rehabilitation details. Cerebellar stroke was excluded from the derivation sample, although some were included in validation. The 3-month follow-up may miss falls that happen later.
Declared interests
The supplied text reports funding from the National Center for Advancing Translational Sciences, National Institutes of Health, USA. It does not include a separate conflict-of-interest statement.
The easy way to misread this
Do not treat this index as a proven discharge test. It was developed in 45 people and validated in a small separate group, and the cut-off scores still need confirmation in larger samples.