Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 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:

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's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:http://oc1dean.blogspot.com/2010/11/my-background-story_8.html

Sunday, June 25, 2017

Factors predicting falls and mobility outcomes in patients with stroke returning home after rehabilitation who are at risk of falling

It would be much better to come up with fall prevention protocols than this piece of laziness. 
http://www.archives-pmr.org/article/S0003-9993(17)30408-2/abstract

Abstract



Objective

To identify factors predicting falls and limited mobility in people with stroke at 12 months after returning home from rehabilitation.


Design

Observational cohort study with 12 month follow-up.


Setting

Community.


Participants

People with stroke (n=144) and increased falls risk discharged home from rehabilitation.


Interventions

Not applicable.


Main Outcome Measures

Falls were measured using monthly calendars completed by participants, and mobility was assessed using gait speed over five metres (high mobility (>0.8m/s) versus low mobility (≤0.8m/s). Both measures were assessed at 12 months post-discharge. Demographics and functional measures including balance, strength, visual or spatial deficits, disability, physical activity level, executive function, functional independence and falls risk were analysed to determine factors significantly predicting falls and mobility levels after 12 months.


Results

Those assessed as being at high falls risk (Falls Risk for Older People in the Community (FROP-Com) score ≥19) were 4.5 times more likely to fall by 12 months (OR:4.506, 95% CI:1.71-11.86, p-value:0.002). Factors significantly associated with lower usual gait speed (<0.8m/s) at 12 months in the multivariable analysis were age (OR:1.07, 95% CI=1.01–1.14, p-value=0.033), physical activity (OR:1.09, 95% CI =1.03-1.17, p-value=0.007) and functional mobility (OR:0.83, 95% CI =0.75-0.93, p-value=0.001).


Conclusion

Several factors predicted falls and limited mobility for patients with stroke 12 months after rehabilitation discharge. These results suggest that clinicians should include assessment of falls risk (FROP-Com), physical activity, and dual task Timed Up and Go during rehabilitation to identify those most at risk of falling and experiencing limited mobility outcomes at 12 months, and target these areas during in-patient and out-patient rehabilitation to optimise long term outcomes.

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