Eline van der Kooi1, Sven Kersten Schiemanck2, Frans Nollet1, Gert Kwakkel3, Jan-Willem Meijer4, Ingrid van de Port5. 1. Department of Rehabilitation Medicine, Academic Medical Center, University of Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands. 2. Department of Rehabilitation Medicine, Leiden University Medical Center, Leiden, The Netherlands. 3. Department of Rehabilitation Medicine, VU University Medical Centre, Amsterdam Movement Sciences, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Department of Physical Therapy and Human Movement Sciences, Northwestern University, Chicago, IL. 4. Department of Rehabilitation Medicine, Revant Rehabilitation Center, Breda, The Netherlands. 5. Department of Rehabilitation Medicine, Revant Rehabilitation Center, Breda, The Netherlands. Electronic address: i.vandeport@revant.nl.
Abstract
OBJECTIVE: To evaluate the association between falls and functional status after stroke. DESIGN: Secondary analysis of data from the randomized 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. SETTING: Nine centers for rehabilitation medicine. PARTICIPANTS: Outpatients after stroke (N=250) with mild cognitive impairments (Mini-Mental State Examination [MMSE] score ≥24), discharged home after inpatient rehabilitation and able to walk 10m independently. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary outcome was the change in Stroke Impact Scale (SIS)-16 score. The independent variable was ≥1 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. RESULTS: Complete data were available for 199 patients, with a mean age of 58±10 years, MMSE score of 28.1±2, and MI score of 130±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=.009). CONCLUSIONS: Almost 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.
RCT Entities:
OBJECTIVE: To evaluate the association between falls and functional status after stroke. DESIGN: Secondary analysis of data from the randomized 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. SETTING: Nine centers for rehabilitation medicine. PARTICIPANTS: Outpatients after stroke (N=250) with mild cognitive impairments (Mini-Mental State Examination [MMSE] score ≥24), discharged home after inpatient rehabilitation and able to walk 10m independently. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The primary outcome was the change in Stroke Impact Scale (SIS)-16 score. The independent variable was ≥1 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. RESULTS: Complete data were available for 199 patients, with a mean age of 58±10 years, MMSE score of 28.1±2, and MI score of 130±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=.009). CONCLUSIONS: Almost 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.
Authors: Corien D M Nikamp; Marte S H Hobbelink; Job van der Palen; Hermie J Hermens; Johan S Rietman; Jaap H Buurke Journal: PLoS One Date: 2019-03-12 Impact factor: 3.240
Authors: Seok Hun Kim; David E Huizenga; Ismet Handzic; Rebecca Edgeworth Ditwiler; Matthew Lazinski; Tyagi Ramakrishnan; Andrea Bozeman; David Z Rose; Kyle B Reed Journal: J Neuroeng Rehabil Date: 2019-08-28 Impact factor: 4.262
Authors: Wycliffe E Wei; Deirdre A De Silva; Hui Meng Chang; Jiali Yao; David B Matchar; Sherry H Y Young; Siew Ju See; Gek Hsiang Lim; Ting Hway Wong; Narayanaswamy Venketasubramanian Journal: BMC Geriatr Date: 2019-12-26 Impact factor: 3.921
Authors: J F Alingh; B M Fleerkotte; A C H Geurts; J H Buurke; B E Groen; J S Rietman; V Weerdesteyn; E H F van Asseldonk Journal: J Neuroeng Rehabil Date: 2021-02-05 Impact factor: 4.262
Authors: R Rössler; S A Bridenbaugh; S T Engelter; R Weibel; D Infanger; E Giannouli; A Sofios; L Iendra; E Portegijs; T Rantanen; L Streese; H Hanssen; R Roth; A Schmidt-Trucksäss; N Peters; T Hinrichs Journal: BMC Neurol Date: 2020-09-16 Impact factor: 2.474