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Fallers after stroke: a retrospective study to investigate the combination of postural sway measures and clinical information in faller's identification.

作者信息

Jonsdottir Johanna, Mestanza Mattos Fabiola Giovanna, Torchio Alessandro, Corrini Chiara, Cattaneo Davide

机构信息

IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.

Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy.

出版信息

Front Neurol. 2023 Apr 27;14:1157453. doi: 10.3389/fneur.2023.1157453. eCollection 2023.


DOI:10.3389/fneur.2023.1157453
PMID:37181569
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10174247/
Abstract

BACKGROUND: Falls can have devastating effects on quality of life. No clear relationships have been identified between clinical and stabilometric postural measures and falling in persons after stroke. OBJECTIVE: This cross-sectional study investigates the value of including stabilometric measures of sway with clinical measures of balance in models for identification of faller chronic stroke survivors, and the relations between variables. METHODS: Clinical and stabilometric data were collected from a convenience sample of 49 persons with stroke in hospital care. They were categorized as fallers ( = 21) or non-fallers ( = 28) based on the occurrence of falls in the previous 6 months. Logistic regression (model 1) was performed with clinical measures, including the Berg Balance scale (BBS), Barthel Index (BI), and Dynamic Gait Index (DGI). A second model (model 2) was run with stabilometric measures, including mediolateral (SwayML) and anterior-posterior sway (SwayAP), velocity of antero-posterior (VelAP) and medio-lateral sway (VelML), and absolute position of center of pressure (CopX abs). A third stepwise regression model was run including all variables, resulting in a model with SwayML, BBS, and BI (model 3). Finally, correlations between independent variables were analyzed. RESULTS: The area under the curve (AUC) for model 1 was 0.68 (95%CI: 0.53-0.83, sensitivity = 95%, specificity = 39%) with prediction accuracy of 63.3%. Model 2 resulted in an AUC of 0.68 (95%CI: 0.53-0.84, sensitivity = 76%, specificity = 57%) with prediction accuracy of 65.3%. The AUC of stepwise model 3 was 0.74 (95%CI: 0.60-0.88, sensitivity = 57%, specificity = 81%) with prediction accuracy of 67.4%. Finally, statistically significant correlations were found between clinical variables ( < 0.05), only velocity parameters were correlated with balance performance ( < 0.05). CONCLUSION: A model combining BBS, BI, and SwayML was best at identifying faller status in persons in the chronic phase post stroke. When balance performance is poor, a high SwayML may be part of a strategy protecting from falls.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b233/10174247/11e13d095022/fneur-14-1157453-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b233/10174247/9b75580c1f38/fneur-14-1157453-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b233/10174247/11e13d095022/fneur-14-1157453-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b233/10174247/9b75580c1f38/fneur-14-1157453-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b233/10174247/11e13d095022/fneur-14-1157453-g002.jpg

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[1]
Fallers after stroke: a retrospective study to investigate the combination of postural sway measures and clinical information in faller's identification.

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引用本文的文献

[1]
Effects of Haptic Feedback Interventions in Post-Stroke Gait and Balance Disorders: A Systematic Review and Meta-Analysis.

J Pers Med. 2024-9-14

[2]
A Computer Vision-Based System to Help Health Professionals to Apply Tests for Fall Risk Assessment.

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本文引用的文献

[1]
Brief composite mobility index predicts post-stroke fallers after hospital discharge.

Front Rehabil Sci. 2022-9-23

[2]
A Systematic Review of Fall Risk Factors in Stroke Survivors: Towards Improved Assessment Platforms and Protocols.

Front Bioeng Biotechnol. 2022-8-8

[3]
Postural control during quiet standing and voluntary stepping response tasks in individuals post-stroke: a case-control study.

Top Stroke Rehabil. 2022-10

[4]
Using Biofeedback to Reduce Step Length Asymmetry Impairs Dynamic Balance in People Poststroke.

Neurorehabil Neural Repair. 2021-8

[5]
The sensitivity and specificity of the balance evaluation systems test-BESTest in determining risk of fall in stroke patients.

NeuroRehabilitation. 2019

[6]
Dynamic balance and instrumented gait variables are independent predictors of falls following stroke.

J Neuroeng Rehabil. 2019-1-7

[7]
Reliability, validity, and responsiveness of three scales for measuring balance in patients with chronic stroke.

BMC Neurol. 2018-9-13

[8]
Comparison of variable selection methods for clinical predictive modeling.

Int J Med Inform. 2018-5-21

[9]
Prediction of Falls in Subjects Suffering From Parkinson Disease, Multiple Sclerosis, and Stroke.

Arch Phys Med Rehabil. 2018-2-1

[10]
Risk of falling in a stroke unit after acute stroke: The Fall Study of Gothenburg (FallsGOT).

Clin Rehabil. 2017-9-11

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