Risk-taking behaviour and executive functions, a major component of the risk of fall factors after recent stroke.
Alain P Yelnik, Ines Dekimèche, Emna Jelili and 4 others
PMID 39439177WHAT IT FOUND
Post-stroke patients with anosognosia, impulsivity, inattention, or perseveration had significantly higher odds of falling in rehab, even after adjusting for physical severity.
Language disorders were not associated with falls. These cognitive signs should guide decisions on supervised walking.
Key findings
01Anosognosia, precipitation (impulsivity), inattention, and perseveration remained independently associated with falls after adjusting for length of stay, FIM, anaesthesia, and hemianopsia.
02Language disorders (motor and sensitive aphasia) were not associated with the occurrence of falls.
03Professionals surveyed identified anosognosia, confusion, inattention, precipitation, and unilateral spatial neglect as the main cognitive disorders perceived to increase fall risk.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Retrospective design, though fall data was prospectively recorded. Single-centre study. Cognitive disorders were identified by clinical reports and rehabilitation needs rather than standardized psychometric testing. NIHSS data was missing for haemorrhagic strokes, limiting severity adjustment in some cases. The influence of medication timing on falls could not be determined.
Declared interests
No specific funding or conflict of interest statements were provided in the text.
The easy way to misread this
Do not assume that unilateral spatial neglect (USN) is an independent risk factor for falls in this context. While USN was associated with falls in the raw data, it lost statistical significance after adjusting for other factors like length of stay and physical severity. The strongest independent predictors were anosognosia, impulsivity, inattention, and perseveration.