Effect of Stroke on Fall Rate, Location and Predictors A Prospective Comparison of Older Adults with and without Stroke 英文参考文献.docVIP

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Effect of Stroke on Fall Rate, Location and Predictors A Prospective Comparison of Older Adults with and without Stroke 英文参考文献.doc

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Effect of Stroke on Fall Rate, Location and Predictors A Prospective Comparison of Older Adults with and without Stroke 英文参考文献

EffectofStrokeonFallRate,LocationandPredictors:A ProspectiveComparisonofOlderAdultswithand withoutStroke LisaA.Simpson1,WilliamC.Miller2*,JaniceJ.Eng3 1Graduate Program in Rehabilitation Sciences, University of British Columbia, Vancouver, Canada, 2Department of Occupational Science and Occupational Therapy, UniversityofBritishColumbia,Vancouver,Canada,3DepartmentofPhysicalTherapy,UniversityofBritishColumbia,Vancouver,Canada Abstract Background:Theliteraturesuggeststhatstrokeisamajorriskfactorforfalls,butthereisalackofprospective,controlled studieswhich quantify fall-risk afterstroke. The purposeof thisstudy wastocompare therates,location andpredictors amongindividualsrecentlydischargedhomefromstrokerehabilitationtoageandsexmatchedcontrols. Methodology/Principal Findings: A sample of 80 people with stroke and 90 controls received baseline assessments of balance, mobility and balance confidence. Falls were recorded prospectively over 13 months for both groups. Group differencesinfallratesandcontributionofclinicalmeasurestofallsweredeterminedusingnegativebinomialregression. Falllocationwascomparedbetweengroupsusingx2statistics.Therateoffallsforindividualswithstrokewas1.77timesthe rateforthecontrolgroup.Peoplewithstrokeweremorelikelytofallathome.Poorerbalance(BergBalanceScale)was associatedwithgreaterfallsforbothstrokeandcontrolgroups(incidencerateratio[IRR]:0.908andIRR:0.877respectively). A faster Timed Up and Go Test was associated with greater falls for the stroke group (IRR: 0.955) while better walking endurance(SixMinuteWalkTest)wasassociatedwithgreaterfallsforthecontrols(IRR:1.004).Balanceconfidencewasnot anindependentpredictorineithergroup. Conclusions:Individualsrecentlydischargedhomeareatgreaterriskoffallingthanindividualswithoutstroke.Attentionto homeenvironmentiswarranted.Balancefunctioncanpredictfallsforbothpeoplewithstrokeandageandsexmatched controls.Increasedmobilitymayincreaseexposuretofallopportunities. Citation:SimpsonLA,MillerWC,EngJJ(2011)Effectof