Does perturbation training prevent falls after discharge from stroke rehabilitation?

Source: Journal of Stroke and Cerebro-Vascular Diseases, 2017, online

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Date of publication: June 2017

Publication type: Journal article

In a nutshell: Individuals with stroke fall frequently, and no exercise intervention has been shown to prevent falls post stroke. Perturbation-based balance training (PBT), which involves practicing reactions to instability, shows promise for preventing falls in older adults and individuals with Parkinson’s disease. This study aimed to determine if PBT during inpatient stroke rehabilitation can prevent falls after discharge into the community. These findings suggest that PBT is promising for reducing falls post stroke. While this was not a randomized controlled trial, this study may provide sufficient evidence for implementing PBT in stroke rehabilitation practice.

Length of publication: 1 page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Falls and fear of falling after stroke

Source: PM&R, 2016, online

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Date of publication: June 2016

Publication type: Journal article

In a nutshell: Falls are common after someone has suffered a stroke, and the consequences are potentially serious. However, few investigations have age-matched the control participants to directly compare with fall characteristics between older adults with and without strokes. Also, fear of falling – a significant psychological consequence of falls – has only been examined to a limited degree as a risk factor for future falls in a stroke population. This observational study aimed to compare the fall history between older adults with and without previous stroke and to identify the determinants of falls and fear of falling in older stroke victims

Length of publication: 1 page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Fall risk post-stroke: Examining paretic limbs around forward gait slips

Source: Journal of Biomechanics, 2016, online

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Date of publication: June 2016

Publication type: Journal article

In a nutshell: Community-dwelling stroke survivors show a high incidence of falls with unexpected external perturbations during dynamic activities like walking. Previous evidence has demonstrated the importance of compensatory stepping to restore dynamic stability in response to perturbations in hemiparetic stroke survivors. However, these studies were limited to either stance perturbations or perturbation induced under the unaffected limb. This study aimed to compare the differences, if any, between the non-paretic and paretic sides in dynamic stability and protective stepping strategies when exposed to unexpected external perturbation during walking.

Length of publication: 1 page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Identifying risk of falls in stroke patients

Source: ProFaNE website

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Date of publication: May 2014

Publication type: News item

In a nutshell: This study compared a new assessment for classifying fallers and non-fallers, called the Stroke Assessment of Fall Risk, with a health system fall risk screening tool, the Fall Harm Risk Screen. The data show that an evidence-derived specific fall risk assessment may more accurately predict falling than a general screen, but additional refinement may be needed.

Length of publication: 1 page

Royal Melbourne Hospital Falls Risk Assessment Tool for post-stroke patients

Source: Journal of Clinical Neuroscience, 2014, Vol 21 no 4 p. 607-611

Follow this link for the abstract

Date of publication: April 2014

Publication type: Journal article

In a nutshell: Falls after a stroke are common and carry a significant disease burden. It is good practice to predict those who are at risk of falls to implement prevention techniques and therapy. This study aimed to determine the validity of a tool developed by the Royal Melbourne Hospital. In both high-risk and medium-risk groups, the tool did not offer sufficient predictive value.

Length of publication: 4 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Classification of falls in stroke rehabilitation

Source: Clinical Rehabilitation, 2013, online

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Date of publication: July 2013

Publication type: Journal article

In a nutshell: This study examined patient characteristics during different types of falls, to compare outcomes of falls to develop a practical falls taxonomy. Four main types of falls were recorded, though with overlapping characteristics. This study asserts that different falls-prevention strategies may be needed for each group/type.

Length of publication: 1 page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Co-ordinated care for vulnerable patients with EMIS Web

Source: NHS Networks

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Date of publication: July 2013

Publication type: Press release

In a nutshell: The Community Rehabilitation team at Cheshire and Wirral Partnership NHS Trust work to ensure their patients, elderly people who have suffered strokes or falls, stay as independent as possible at home and are not transferred to hospital. To this end they work with an electronic patient record system via EMIS Web, which allows them to improve communication and workload planning. It is also hoped that the system will drive up efficiencies in patient care.

Length of publication: 1 page

NICE guideline update: older people at risk of hospital falls

Source: National Institute for Health and Care Excellence website

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Date of publication: June 2013

Publication type: Website news item

In a nutshell: New NICE guidelines published last month state that health professionals should consider patients over 65, or those over 50 with certain conditions such as strokes, as being high risk for falling while in hospital. Falls cost the NHS around £2.3 billion per year, and may cause death, serious injury such as fractures or head injuries, and minor cuts and bruises. The guidance calls for clinicians to assess risks of falling and consider multifactorial interventions.

Length of publication: 1 page

Use of Predict FIRST to predict falls in stroke patients

Source: Clinical Rehabilitation, 2012, 26 (12)

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Date of publication: November 2012

Publication type: Journal article

In a nutshell: The Prediction of Falls In Rehabilitation Settings Tool (Predict FIRST) can be used alongside motor function to identify those most at risk of falls in the six weeks following a stroke. This study compared this tool to the real falls frequency to test its accuracy. While Predict FIRST has the ability to make good predictions, it was found to underestimate the risk of falls overall.

Length of publication: 1 page

Some important notes:  Please contact your local NHS Library for the full text of this article. Follow this link to find your local NHS Library.

Identifying older people at high risk of future falls

Source: Emergency Medicine Journal

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Date of publication: Online November 2012

Publication type: Journal article

In a nutshell: A simple, two item screening tool has been developed in Australia, measuring people over 70 years old with a history of falls for their physical status, medical and fall history and use of community services. The tool can accurately discriminate between fallers and non-fallers, and could possibly identify high-risk individuals who may benefit from further help after discharge.

Length of publication: 1 page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Effects of a multifactorial falls prevention program for stroke victims

Source: Archives of Physical Medicine and Rehabilitation, 2012, 93 (9), p. 1648-1655

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Date of publication: September 2012

Publication type: Journal article

In a nutshell: This trial investigated if a multifactorial falls prevention program would reduce falls in stroke victims, and whether the program would leads to improvements in gait, balance, strength and fall-related efficacy. It found there to be no significant difference in fall rate, and no improvements were found.

Length of publication: 7 pages

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Yoga-based rehabilitation after stroke can potentially improve balance and function

Source:  Nursing Times 1st August 2012

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Date of publication: August 2012

Publication type: journal article

In a nutshell: The Daily Telegraph drew an inadequate summary from a headline in the journal Stroke. This article attempts to redress the balance, by pointing out that there is no evidence to state that yoga will improve balance and function, but there is evidence to suggest that it might. It also points out that there is no evidence to say that yoga is more beneficial to people who have had a stroke than normal care.

Length of publication: 1 page

Some important notes: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

Program not effective in reducing falls in stroke victims

Source: Archives of Physical Medicine and Rehabilitation, 2012, 93 (9), p. 1648-1655

Follow this link for abstract

Date of publication: September 2012

Publication type: Journal article

In a nutshell: A number of stroke victims were put into a multifactorial falls prevention program to see if this would help improve their gait, balance and strength and lead to fewer falls at home. However, it was found to be no more effective than usual care in any of these areas.

Length of publication: 7 pages

Some important information: Please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.

An integrative review of factors associated with falls during post-stroke rehabilitation

Source: Journal of Nursing Scholarship, early view (published online 13 October 2010)

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Date of publication: October 2010

Publication type: Journal article

In a nutshell: An integrative review was carried out to examine the evidence concerning risk factors for falls during inpatient rehabilitation for stroke. Fourteen studies met the inclusion criteria from the literature search spanning the period 1990 to 2009. Of these, one study provided high quality evidence whilst the remaining articles were primarily qualitative or descriptive in nature. A total of twenty-eight unique risk factors were identified across all of the studies. Overall, impaired balance, visuospatial hemineglect and self-care deficits were identified as key risk factors whilst the association between post-stroke falls with age, incontinence and impaired vision was not supported.

Length of publication: 10 pages