Journal of Rehabilitation Research & Development (JRRD)

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Volume 50 Number 9, 2013
   Pages 1277 — 1286

Abstract — Circumstances and consequences of falls among people with chronic stroke

Arlene A. Schmid, PhD, OTR;1–5* H. Klar Yaggi, MD;6 Nicholas Burrus, BA;1 Vincent McClain, MD;7 Charles Austin, BFA, MDiv;1 Jared Ferguson, BS;1 Carlos Fragoso, MD;6 Jason J. Sico, MD;6 Edward J. Miech, EdD;1–2,5 Marianne S. Matthias, PhD;1,5,8 Linda S. Williams, MD;1–2,4–5,9 Dawn M. Bravata, MD1–2,5,9

1Health Services Research and Development (HSR&D) Center of Excellence on Implementing Evidence-Based Practice, Richard L. Roudebush Department of Veterans Affairs (VA) Medical Center, Indianapolis, IN; 2VA HSR&D Stroke Quality Enhancement Research Initiative, Indianapolis, IN; 3Department of Occupational Therapy, School of Health and Rehabilitation Sciences, and 4Center for Aging Research, Indiana University, Indianapolis, IN; 5Regenstrief Institute Inc, Indianapolis, IN; 6Yale University School of Medicine, New Haven, CT; 7Rushford Center, Middletown, CT; 8Department of Communication Studies and 9School of Medicine, Indiana University, Indianapolis, IN

Abstract — Falls are common after stroke; however, circumstances and consequences are relatively unknown. Our objectives were to identify the differences between fallers and ??non-fallers among people with chronic stroke, identify the circumstances of fall events, and examine the consequences of the falls. This is a secondary data analysis; all participants included sustained a stroke. Variables included demographics, stroke characteristics, and comorbidities. Falls were collected via self-report, and circumstances and consequences were derived from participant description of the event and categorized as appropriate. Among 160 participants, 53 (33%) reported a fall during the 1 yr period. Circumstances of falls were categorized as intrinsic or extrinsic. Location and circumstance of the fall were included: 70% occurred at home and 40% were associated with impaired physical or mental state (e.g., inattention to tying shoes). Additionally, 21% of falls were associated with activities of daily living and mobility and 34% with slips or trips. The majority who fell sustained an injury (72%). Injuries ranged from bruising to fractures, and 55% of those with an injury sought medical care (32% to emergency department). Poststroke falls are associated with an alarming rate of injury and healthcare utilization. Targeting mental and physical states may be key to fall prevention.

Key words: activities of daily living, circumstances, consequences, disability, emergency, falls, injury, mobility, rehabilitation, stroke.


View HTML  ¦  View PDF  ¦  Contents Vol. 50, No. 9
This article and any supplementary material should be cited as follows:
Schmid AA, Yaggi HK, Burrus N, McClain V, Austin C, Ferguson J, Fragoso C, Sico JJ, Miech EJ, Matthias MS, Williams LS, Bravata DM. Circumstances and consequences of falls among people with chronic stroke. J Rehabil Res Dev. 2013;50(9):1277–86.
http://dx.doi.org/10.1682/JRRD.2012.11.0215
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