Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
PLoS One. 2011 Apr 29;6(4):e19431. doi: 10.1371/journal.pone.0019431.
The literature suggests that stroke is a major risk factor for falls, but there is a lack of prospective, controlled studies which quantify fall-risk after stroke. The purpose of this study was to compare the rates, location and predictors among individuals recently discharged home from stroke rehabilitation to age and sex matched controls.
METHODOLOGY/PRINCIPAL FINDINGS: A sample of 80 people with stroke and 90 controls received baseline assessments of balance, mobility and balance confidence. Falls were recorded prospectively over 13 months for both groups. Group differences in fall rates and contribution of clinical measures to falls were determined using negative binomial regression. Fall location was compared between groups using χ(2) statistics. The rate of falls for individuals with stroke was 1.77 times the rate for the control group. People with stroke were more likely to fall at home. Poorer balance (Berg Balance Scale) was associated with greater falls for both stroke and control groups (incidence rate ratio [IRR]: 0.908 and IRR: 0.877 respectively). A faster Timed Up and Go Test was associated with greater falls for the stroke group (IRR: 0.955) while better walking endurance (Six Minute Walk Test) was associated with greater falls for the controls (IRR: 1.004). Balance confidence was not an independent predictor in either group.
Individuals recently discharged home are at greater risk of falling than individuals without stroke. Attention to home environment is warranted. Balance function can predict falls for both people with stroke and age and sex matched controls. Increased mobility may increase exposure to fall opportunities.
文献表明，中风是跌倒的一个主要危险因素，但缺乏前瞻性、对照研究来量化中风后跌倒的风险。本研究的目的是比较最近从中风康复出院的个体与年龄和性别匹配的对照组之间的跌倒发生率、地点和预测因素。
方法/主要发现：对 80 名中风患者和 90 名对照者进行了基线平衡、移动和平衡信心评估。对两组患者进行了为期 13 个月的前瞻性跌倒记录。使用负二项回归确定了组间跌倒率差异和临床指标对跌倒的贡献。使用 χ(2)检验比较组间跌倒地点的差异。中风患者的跌倒率是对照组的 1.77 倍。中风患者更有可能在家中跌倒。平衡较差（伯格平衡量表）与中风和对照组的跌倒发生率增加相关（发病率比[IRR]：0.908 和 IRR：0.877）。Timed Up and Go 测试较快与中风组的跌倒发生率增加相关（IRR：0.955），而步行耐力较好（六分钟步行测试）与对照组的跌倒发生率增加相关（IRR：1.004）。平衡信心在两组中都不是独立的预测因素。
最近出院回家的个体跌倒风险高于没有中风的个体。需要注意家庭环境。平衡功能可以预测中风患者和年龄及性别匹配的对照组的跌倒。移动能力的增加可能会增加跌倒的机会。
