Publication
Estimated Risk for Falls Among Community-Dwelling Stroke Survivors Referred to Outpatient Physiotherapy
| dc.contributor.author | Pimenta, C | |
| dc.contributor.author | Correia, A | |
| dc.contributor.author | Alves, M | |
| dc.contributor.author | Virella, D | |
| dc.date.accessioned | 2019-06-03T15:42:28Z | |
| dc.date.available | 2019-06-03T15:42:28Z | |
| dc.date.issued | 2019-05 | |
| dc.description.abstract | Title: Estimated risk for falls among community-dwelling stroke survivors referred to outpatient physiotherapy Authors: Carla Pimenta1,2, Anabela Correia1,2, Marta Alves3, Daniel Virella3 1. Physiotherapy Department, Hospital Curry Cabral, Centro Hospitalar Universitário Lisboa Central, Portugal. 2. Department of Rehabilitation Science and Technology, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal. 3. Epidemiology and Statistics Office of the Research Unit, Centro Hospitalar Universitário Lisboa Central, Portugal. Background: In the sub-acute phase of stroke, most of the patients with moderate or severe impairments typically attend in-patient rehabilitation. Functional recovery continues after discharge and patients can benefit of outpatient physiotherapy. Homecoming may lead to an increased risk for falls, as the patient is no longer in a protected environment. The physiotherapy assessment should identify the risk of falling, in order to minimize it. Purpose: To estimate the risk for falls among community-dwelling stroke survivors referred to the outpatient physiotherapy in a tertiary care hospital and to explore factors associated with increased risk for falls. Methods: Observational, cross-sectional study with nested case-control study, of individuals referred to the physiotherapy department less than 12 months after stroke and able to walk independently. A referral period of 4 years was considered. Three functional tools were applied: Berg Balance Scale (BBS), Timed Up and Go Test (TUG) and the Motor Assessment Scale (MAS); demographic and clinical data were collected. Risk for falls was defined as BBS≤45 or TUG³14. Independent variables to include in the multivariable logistic regression model were identified by Chi- Square test and Mann-Whitney test. Results: Of 217 individuals referred for ambulatory treatment, 140 fulfilled the inclusion criteria. Patients were 21 to 87 years old (median 66), 80 males, in 109 the stroke occurred in the lasts 6 months, 117 had ischemic stroke and in 29 it was a recurrent stroke. Risk for falls was identified in 117 individuals (83.6% [95%CI 76.6 - 88.8]); 95 cases were identified by both BBS and TUG, 12 only by BBS and 10 by TUG alone. The model for risk for falls included age, gender and MAS shows that for each increase in one year of age, the odds for falls increased 10% (adjusted OR 1.10; 95%CI 1.04 – 1.17; p=0.002), odds for falls was 14 fold higher in females (adjusted OR 14.43; 95%CI 1.89 – 110.12; p=0.010) and for each increase in MAS units, the odds for falls decreased 23% (adjusted OR 0.77; 95%CI 0.66 – 0.88; p<0.001). Conclusions: Estimated risk for falls is very frequent after stroke (75-90%), especially in the elder and in females; it is associated with lower autonomous functionality. Evidence is needed for the adequate physiotherapy interventions to prevent falls after stroke, customized by standardized risk assessment. Implications: The identification of the risk for falls and its causes, such as the balance disorders should be translated into physical therapy practice. Keywords: Fall, stroke, balance disorder, functionality, risk assessment. Funding acknowledgements: No external funding was granted to this study. Brief biography of presenting author: Carla Pimenta (presenting author) is a Physiotherapist with a graduation from the Escola Superior de Tecnologia da Saúde de Lisboa (ESTESL) and a MSc degree in Social and Organizational Intervention in Health from the Universidade de Évora / ESTESL. Presently, works as a physiotherapist, in a multidisciplinary team at the Rehabilitation Department in a tertiary hospital in Lisbon (Hospital Curry Cabral, Centro Hospitalar Universitário Lisboa Central) and as an invited assistant, teaching at ESTESL. In more than 20 years of hospital practice has already worked in several departments that request physiotherapy interventions, with in and outpatients. Since 2001, is mainly dedicated to the area of neuromuscular therapy, with patients with neurological disorders in sub-acute phase, admitted to the rehabilitation department and follow up immediately after hospital discharge (essentially strokes, traumatic head injuries and neurosurgery patients). Information concerning any presentations or publications of the work made prior to congress: No presentation or publication of this work was done before the congress; however, the authors are writing a manuscript and intend to publish. Pimenta C, Correia A, Alves M, Virella D. (2009) Estimated risk for falls among community-dwelling stroke survivors referred to outpatient physiotherapy (Postrer). Geneve: World Conference for Physical Therapy | pt_PT |
| dc.description.version | info:eu-repo/semantics/publishedVersion | pt_PT |
| dc.identifier.citation | IN: World Confederation for Physical Therapy; 2019, 10 a 13 Mai. Geneva, Switzerland | pt_PT |
| dc.identifier.uri | http://hdl.handle.net/10400.17/3268 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Serviço de Medicina Física e Reabilitação e Centro de Investigação do Centro Hospitalar Universitário de Lisboa Central, EPE | pt_PT |
| dc.subject | CHLC MFR | pt_PT |
| dc.subject | CHLC CINV | pt_PT |
| dc.subject | Falls | pt_PT |
| dc.subject | Stroke | pt_PT |
| dc.subject | Physiotherapy | pt_PT |
| dc.title | Estimated Risk for Falls Among Community-Dwelling Stroke Survivors Referred to Outpatient Physiotherapy | pt_PT |
| dc.type | other | |
| dspace.entity.type | Publication | |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | other | pt_PT |
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