Fuck, fuck, fuck. More useless predictions rather than coming up with recovery solutions that would prevent such falls. Does no one understand that survivors don't give a shit about fall prediction? They want 100% recovery. GET THERE!
Dynamic balance and instrumented gait variables are independent predictors of falls following stroke
- Kelly BowerEmail authorView ORCID ID profile,
- Shamala Thilarajah,
- Yong-Hao Pua,
- Gavin Williams,
- Dawn Tan,
- Benjamin Mentiplay,
- Linda Denehy and
- Ross Clark
Journal of NeuroEngineering and Rehabilitation201916:3
© The Author(s). 2019
- Received: 3 September 2018
- Accepted: 19 December 2018
- Published: 7 January 2019
Abstract
Background
Falls are common following
stroke and are frequently related to deficits in balance and mobility.
This study aimed to investigate the predictive strength of gait and
balance variables for evaluating post-stroke falls risk over 12 months
following rehabilitation discharge.
Methods
A prospective cohort study was
undertaken in inpatient rehabilitation centres based in Australia and
Singapore. A consecutive sample of 81 individuals (mean age 63 years;
median 24 days post stroke) were assessed within one week prior to
discharge. In addition to comfortable gait speed over six metres (6mWT),
a depth-sensing camera (Kinect) was used to obtain fast-paced gait
speed, stride length, cadence, step width, step length asymmetry, gait
speed variability, and mediolateral and vertical pelvic displacement.
Balance variables were the step test, timed up and go (TUG), dual-task
TUG, and Wii Balance Board-derived centre of pressure velocity during
static standing. Falls data were collected using monthly calendars.
Results
Over 12 months, 28% of
individuals fell at least once. The faller group had increased TUG time
and reduced stride length, gait speed variability, mediolateral and
vertical pelvic displacement, and step test scores (P < 0.001–0.048).
Significant predictors, when adjusted for country, prior falls and
assistance (i.e., physical assistance and/or gait aid use) were stride
length, step length asymmetry, mediolateral pelvic displacement, step
test and TUG scores (P < 0.040;
IQR-odds ratio(OR) = 1.37–7.85). With comfortable gait speed as an
additional covariate, to determine the additive benefit over standard
clinical assessment, only mediolateral pelvic displacement, TUG and step
test scores remained significant (P = 0.001–0.018; IQR-OR = 5.28–10.29).
Conclusions
Reduced displacement of the
pelvis in the mediolateral direction during walking was the strongest
predictor of post-stroke falls compared with other gait variables.(Well, then create a protocol that has correct pelvis placement. )
Dynamic balance measures, such as the TUG and step test, may better
predict falls than gait speed or static balance measures.
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