Falls in community-dwelling stroke survivors: an accumulated impairments model.

Abstract

Two hundred eighty subjects were included. Falls were reported by 142 subjects (51%) between 1 month and 6 months poststroke. Univariate analysis revealed that the risk of falling for subjects with motor impairment only was odds ratio (OR) = 2.2 (95% confidence interval [CI] 1.05 to 4.70), motor + sensory impairments OR = 3.1 (95% CI 1.46 to 6.79), and motor + sensory + visual impairments OR = 2.4 (95% CI 1.05 to 5.83) as compared to the group with no motor, sensory, and visual impairments. In multiple logistic regression, the risk of falling increased with motor impairment only and motor + sensory impairments. However, the motor + sensory + visual impairments group had a lower risk of falling. Secondary analysis revealed a significant difference in mobility scores (Orpington Prognostic Scale-balance) among individuals with motor impairment only, motor + sensory impairments, motor + sensory + visual impairments, and the reference group. This lower risk of falling in stroke survivors with motor + sensory + visual impairments may be explained by more involved strokes, more impaired balance, and subsequently less mobility, therefore, lowering their risk of falling. In conclusion, community-dwelling persons who have had a stroke are at a higher risk of falling. However, the risk of falling is not linearly related to the number of impairments. Individuals with motor, sensory, and visual impairments are less mobile and less likely to fall than those individuals with motor deficits only or motor and sensory deficits.