Deans' stroke musings: Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke

Changing stroke rehab and research worldwide now.Time is Brain! trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 523 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

My blog is not to help survivors recover, it is to have the 10 million yearly stroke survivors light fires underneath their doctors, stroke hospitals and stroke researchers to get stroke solved. 100% recovery. The stroke medical world is completely failing at that goal, they don't even have it as a goal. Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It lays out what needs to be done to get stroke survivors closer to 100% recovery. It's quite disgusting that this information is not available from every stroke association and doctors group.

Saturday, January 9, 2016

Effectiveness of a fall-risk reduction programme for inpatient rehabilitation after stroke

This is so obvious that there should be a standard fall prevention protocol across the world that could effectively prevent this problem from happenning. But that would require leadership and strategy from our fucking failures of stroke associations. That's not going to happen.
http://www.tandfonline.com/doi/abs/10.3109/09638288.2015.1107771

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DOI:: 10.3109/09638288.2015.1107771

Nika Goljar^a^b, Daniel Globokar^a, Nataša Puzić^a, Natalija Kopitar^a, Maja Vrabič^a, Matic Ivanovski^a & Gaj Vidmar^a^c^*

Publishing models and article dates explained

Received: 15 Apr 2014
Accepted: 10 Oct 2015
Published online: 04 Jan 2016

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Abstract

Purpose: To evaluate effectiveness of fall-risk-assessment-based fall prevention for stroke rehabilitation inpatients.

Method: A consecutive series of 232 patients admitted for the first time to a subacute stroke-rehabilitation ward during 2010–2011 was studied in detail. The Assessment Sheet for Fall Prediction in Stroke Inpatients (ASFPSI by Nakagawa et al.) was used to assess fall-risk upon admission. Association of ASFPSI score and patient characteristics with actual falls was statistically tested. Yearly incidence of falls per 1000 hospital days (HD) was retrospectively audited for the 2006–2014 period to evaluate effectiveness of fall-risk reduction measures.

Results: The observed incidence of falls over the detailed-study-period was 3.0/1000 HD; 39% of the fallers fell during the first week after admission. ASFPSI score was not significantly associated with falls. Longer hospital stay, left body-side affected and non-extreme FIM score (55–101) were associated with higher odds of fall. Introduction of fall-risk reduction measures followed by compulsory fall-risk assessment lead to incidence of falls dropping from 7.1/1000 HD in 2006 to 2.8/1000 HD in 2011 and remaining at that level until 2014.

Conclusions: The fall-risk-assessment-based measures appear to have led to decreasing falls risk among post-stroke rehabilitation inpatients classified as being at high risk of falls. The fall prevention programme as a whole was successful. Patients with non-extreme level of functional independence should receive enhanced fall prevention.

Implications for Rehabilitation
Recognising the fall risk upon the patient's admission is essential for preventing falls in rehabilitation wards.
Assessing the fall risk is a team tasks and combines information from various sources.
Assessing fall risk in stroke patients using the assessment sheet by Nakagawa et al. immediately upon admission systematically draws attention to the risk of falls in each individual patient.