Background
Falls
are common among community-dwelling stroke survivors. The aims of this
study were (1) to compare motor and cognitive outcomes between
individuals who fell in the 6 months' postdischarge from in-patient
stroke rehabilitation and those who did not fall, and (2) to explore
potential mechanisms underlying the relationship between falls and
recovery of motor and cognitive function.
Methods
Secondary
analysis of a prospective cohort study of individuals discharged home
from in-patient rehabilitation was conducted. Participants were
recruited at discharge and completed a 6-month falls monitoring period
using postcards with follow-up. Nonfallers and fallers were compared at
the 6-month follow-up assessment on the Berg Balance Scale (BBS), the
Chedoke–McMaster Stroke Assessment (CMSA), gait speed, and the Montreal
Cognitive Assessment (MoCA). Measures of balance confidence and physical
activity were also assessed.
Results
Twenty-three
fallers were matched to 23 nonfallers on age and functional balance
scores at discharge. A total of 43 falls were reported during the study
period (8 participants fell more than once). At follow-up, BBS scores (P = .0066) and CMSA foot scores (P = .0033) were significantly lower for fallers than for nonfallers. The 2 groups did not differ on CMSA leg scores (P = .049), gait speed (P = .47), or MoCA score (P
= .23). There was no significant association between change in balance
confidence scores and change in physical activity levels among all
participants from the first and third questionnaire (r = .27, P = .08).
Conclusions
Performance
in balance and motor recovery of the foot were compromised in fallers
when compared to nonfallers at 6 months post discharge from in-patient
stroke rehabilitation.
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