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Volume 45 Number 8, 2008
   Pages 1195 — 1214

Abstract - Falls in individuals with stroke

Vivian Weerdesteyn, PhD, PT;1-2* Mark de Niet, MSc;1 Hanneke J. R. van Duijnhoven, MSc;1 Alexander C. H. Geurts, MD, PhD1-2

1Department of Rehabilitation, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands; 2Sint Maartenskliniek Research, Development and Education, Nijmegen, the Netherlands

Abstract — Stroke survivors are at high risk for falls in all poststroke stages. Falls may have severe consequences, both physically and psychosocially. Individuals with stroke have an increased risk for hip fractures, and after such a fracture, they less often regain independent mobility. In addition, fear of falling is a common consequence of falls, which may lead to decreased physical activity, social deprivation and, eventually, loss of independence. Important risk factors for falls are balance and gait deficits. Stroke-related balance deficits comprise reduced postural stability during quiet standing and delayed and less coordinated responses to both self-induced and external balance perturbations. Gait deficits include reduced propulsion at push-off, decreased hip and knee flexion during the swing phase, and reduced stability during the stance phase. Interventions addressing these deficits can be expected to prevent falls more successfully. Preliminary evidence shows that task-specific exercise programs targeting balance and gait deficits can indeed reduce the number of falls in individuals with stroke. Technological advances in assistive devices are another promising area. More research is needed, however, to provide conclusive evidence of the efficacy of these interventions regarding the prevention of falls in individuals with stroke.

Key words: accidental falls, balance, cerebrovascular accident, fall circumstances, fall injuries, gait, postural control, prevention of falls, rehabilitation, stroke.

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