Slip-Fall Predictors in Community-Dwelling, Ambulatory Stroke Survivors: A Cross-sectional Study.
Rachana Gangwani, Shamali Dusane, Shuaijie Wang and 4 others
PMID 32815890WHAT IT FOUND
In community-dwelling stroke survivors, a combination of dynamic gait stability, Timed Up and Go time, and hip extensor strength predicted who would fall when a slip was simulated.
A 13-second TUG time and hip extensor strength below 106 Nm were key cutoffs.
Key findings
01A multivariable model using dynamic gait stability, Timed Up and Go (TUG), and hip extensor strength predicted laboratory-induced slip falls with 77.3% accuracy.
02Fallers had significantly slower TUG times and weaker hip extensors than non-fallers, with cutoff scores of 13 seconds for TUG and 106 Nm for hip extensor strength.
03Common clinical measures like the Berg Balance Scale, Fugl-Meyer Assessment, and self-reported fall history did not predict slip falls in this group.
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
The study included only ambulatory, high-functioning stroke survivors (mean Berg score 48.41), so findings do not apply to those with severe impairments or acute stroke. Laboratory-induced slips may not perfectly replicate the complexity and unpredictability of real-world falls. Dynamic gait stability requires motion capture or specialized wearable sensors, which may not be available in all clinics, though the authors note emerging cost-effective sensor options. The study was cross-sectional; it identifies predictors of a single simulated event but does not track real-world fall incidence over time.
Declared interests
The authors declare no conflict of interest. The study was supported by the National Institute of Health (Extramural).
The easy way to misread this
Do not assume that a patient's self-reported confidence (ABC scale) or past year's fall history accurately reflects their physical risk for slipping. In this study, nearly half of the participants fell despite reporting high confidence and no correlation with past falls. Objective measures of strength and mobility are required.