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PHYST-818; No. of Pages 8 ARTICLE IN PRESS
Physiotherapy xxx (2015) xxx–xxx
Do measures of reactive balance control predict falls in
people with stroke returning to the community?
A. Mansfield a,b,c,∗, J.S. Wong a,b , W.E. McIlroy a,b,c,d , L. Biasin a,b ,
K. Brunton a,b , M. Bayley a,b,c , E.L. Inness a,b
a Toronto Rehabilitation Institute–University Health Network, Toronto, ON, Canada
b University of Toronto, Toronto, ON, Canada
c Sunnybrook Health Sciences Centre, Toronto, ON, Canada
d University of Waterloo, Waterloo, ON, Canada
Abstract
Objective To determine if reactive balance control measures predict falls after discharge from stroke rehabilitation.
Design Prospective cohort study.
Setting Rehabilitation hospital and community.
Participants Independently ambulatory individuals with stroke who were discharged home after inpatient rehabilitation (n = 95).
Main outcome measures Balance and gait measures were obtained from a clinical assessment at discharge from inpatient stroke rehabilitation.
Measures of reactive balance control were obtained: (1) during quiet standing; (2) when walking; and (3) in response to large postural
perturbations. Participants reported falls and activity levels up to 6 months post-discharge. Logistic and Poisson regressions were used to
identify measures of reactive balance control that were related to falls post-discharge.
Results Decreased paretic limb contribution to standing balance control [rate ratio 0.8, 95% confidence interval (CI) 0.7 to 1.0; P = 0.011],
reduced between-limb synchronisation of quiet standing balance control (rate ratio 0.9, 95% CI 0.8 to 0.9; P < 0.0001), increased step length
variability (rate ratio
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