Functional Reach, Depression Scores, and Number of Medications Are Associated With Number of Falls in People With Chronic Stroke.
Aqeel M Alenazi, Mohammed M Alshehri, Shaima Alothman and 4 others
PMID 29288141WHAT IT FOUND
In people with chronic stroke, more medications and higher depression scores predicted more falls.
Functional reach distance also predicted falls, with a cutoff of 18.15 cm for recurrent falls. Other common tests like Berg Balance and Timed Up and Go did not distinguish fallers.
Key findings
01Number of medications and depression scores were the only significant predictive factors for falls, with each additional medication increasing risk by 9% and higher depression scores increasing risk by 11%.
02Functional Reach Test was the only balance assessment significantly associated with falls, where decreased reach increased fall risk, and a cutoff of 18.15 cm identified recurrent fallers.
03Common mobility tests including Berg Balance Scale, Timed Up and Go, and gait speed did not significantly predict falls in this prospective analysis.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
This was a secondary analysis of a trial designed for a different purpose, meaning fall data was collected as part of a study on orthotics. Participants received physical therapy and home exercise programs during the study, which may have influenced fall rates. The recurrent faller group was relatively small (n=24), which may affect statistical power. Fall data relied on participant recall over intervals of up to 6 weeks, introducing potential recall bias. The study did not analyze the specific types or dosages of medications, only the total number.
Declared interests
The study was supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) and the Department of Education. The authors declared no conflicts of interest.
The easy way to misread this
Do not assume that a patient with a normal Berg Balance Scale or Timed Up and Go score is at low risk for falls. This study found these common tests did not predict falls, while medication count and depression did.