The effect of spasticity, sense and walking aids in falls of people after chronic stroke

Disabil Rehabil. 2007 May 15;29(9):679-87. doi: 10.1080/09638280600925860.

Abstract

Objective: To study the effects of spasticity, sensory impairment, and type of walking aid on falls in community dwellers with chronic stroke.

Methods: Functional Independence Measure (FIM) Instrument, Joint Position Sense Evaluation (JPS), the Rivermead motor assessment scale (RMA), Ashworth Scale, Tinetti Assessment Tool were used to assess 100 cases.

Results: Fifty-three of the cases were grouped as nonfallers, 36 as one-time fallers and 11 as repeat fallers. These 3 groups were found to be different from each other in respect to FIM, Tinetti test and RMA (p < 0.001). In respect to knee JPS, nonfallers and one-time faller groups were found to be different from repeat fallers (p = 0.001). There is a difference among the groups in respect to Ashworth assessment (p < 0.001), use of walking aid (p = 0.01) and type of walking aid (p = 0.01). Some 43% of the cases use a walking aid (58.1% cane, 41.9% high cane). According to Ordinal logistic regression analysis, it was found that the possibility of fall increased (p < 0.01), as the value of spasticity increased while the possibility of the fall of the individuals with stroke decreased (p < 0.00 - 0.01) as Tinetti, RMA and FIM variables increased.

Conclusions: In respect to falls, spasticity is also an indicator for chronic stroke patients, as is motor impairment, functional situation, impairment of balance and walking. Sensory impairment, using a walking aid and the type were found to be ineffective.

MeSH terms

  • Accidental Falls / statistics & numerical data*
  • Adult
  • Canes*
  • Disability Evaluation
  • Female
  • Humans
  • Joints / physiopathology
  • Logistic Models
  • Male
  • Middle Aged
  • Muscle Spasticity / physiopathology*
  • Postural Balance / physiology
  • Psychomotor Performance / physiology*
  • Stroke / physiopathology*
  • Walking / physiology