Prediction of Post-stroke Falls by Quantitative Assessment of Balance
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Objective To evaluate characteristics of the postural instability in patients with stroke and to present a prediction model of post-stroke falls.Methods Patients with a first-ever stroke who had been evaluated by the Balance Master (BM) at post-stroke 3 months (±1 month) between August 2011 and December 2015 were enrolled. Parameters for the postural instability, such as the weight bearing asymmetry (WBA) and postural sway velocity (PSV), were obtained. The fall events in daily lives were assessed via structured telephone interview with a fall related questionnaire.Results A total of 71 patients (45 men; 45 with ischemic stroke) were enrolled in this study. All subjects underwent BM evaluation at 3.03±0.40 months after stroke. The mean WBA was 17.18%±13.10% and mean PSV (measured as o/s) were noted as 0.66±0.37 (eyes-open on firm surface), 0.89±0.75 (eyes-closed on firm surface), 1.45±1.09 (eyes-open on soft surface), and 3.10±1.76 (eyes-closed on soft surface). A prediction model of post-stroke falls was drawn by multiple logistic regression analysis as follows: Risk of post-stroke falls = -2.848 + 1.878 x (PSVECSS) + 0.154 x (age=1 if age≥65; age=0 if age<65).Conclusion The weight bearing asymmetry and postural sway were significantly increased in patients with stroke. Older age and impaired postural control increased the risk of post-stroke falls.
Abstract
Objective To evaluate characteristics of the postural instability in patients with stroke and to present a prediction model of post-stroke falls.Methods Patients with a first-ever stroke who had been evaluated by the Balance Master (BM) at post-stroke 3 months (±1 month) between August 2011 and December 2015 were enrolled. Parameters for the postural instability, such as the weight bearing asymmetry (WBA) and postural sway velocity (PSV), were obtained. The fall events in daily lives were assessed via structured telephone interview with a fall related questionnaire.Results A total of 71 patients (45 men; 45 with ischemic stroke) were enrolled in this study. All subjects underwent BM evaluation at 3.03±0.40 months after stroke. The mean WBA was 17.18%±13.10% and mean PSV (measured as o/s) were noted as 0.66±0.37 (eyes-open on firm surface), 0.89±0.75 (eyes-closed on firm surface), 1.45±1.09 (eyes-open on soft surface), and 3.10±1.76 (eyes-closed on soft surface). A prediction model of post-stroke falls was drawn by multiple logistic regression analysis as follows: Risk of post-stroke falls = -2.848 + 1.878 x (PSVECSS) + 0.154 x (age=1 if age≥65; age=0 if age<65).Conclusion The weight bearing asymmetry and postural sway were significantly increased in patients with stroke. Older age and impaired postural control increased the risk of post-stroke falls.
참고문헌 (39)
- Herman B, "Epidemiology of stroke in Tilburg, the Netherlands. The population-based stroke incidence register. 2: Incidence, initial clinical picture and medical care, and three-week case fatality", Stroke, 13, pp.629~634 (1982)
- Hochstenbach J, "Long-term outcome after stroke: a disability-orientated approach", Int J Rehabil Res, 19, pp.189~200 (1996)
- Bohannon RW, "Standing balance and function over the course of acute rehabilitation", Arch Phys Med Rehabil, 76, pp.994~996 (1995)
- Fong KN, "Relationship of motor and cognitive abilities to functional performance in stroke rehabilitation", Brain Inj, 15, pp.443~453 (2001)
- Keenan MA, "Factors affecting balance and ambulation following stroke", Clin Orthop Relat Res, (182), pp.165~171 (1984)
- Sandin KJ, "The measure of balance in sitting in stroke rehabilitation prognosis", Stroke, 21, pp.82~86 (1990)
- Cathie AG, "The influence of the lower extremities upon the structural integrity of the body", J Am Osteopath Assoc, 49, pp.443~446 (1950)
- Nashner LM, "The organization of human postural movements: a formal basis and experimental synthesis", Behav Brain Sci, 8, pp.135~150 (1985)
- Kamphuis JF, "Is weight-bearing asymmetry associated with postural instability after stroke? A systematic review", Stroke Res Treat, 2013, pp.692137~ (2013)
- Mackintosh SF, "Balance score and a history of falls in hospital predict recurrent falls in the 6 months following stroke rehabilitation", Arch Phys Med Rehabil, 87, pp.1583~1589 (2006)
- Weerdesteyn V, "Falls in individuals with stroke", J Rehabil Res Dev, 45, pp.1195~1213 (2008)
- Forster A, "Incidence and consequences of falls due to stroke: a systematic inquiry", BMJ, 311, pp.83~86 (1995)
- Nyberg L, "Patient falls in stroke rehabilitation. A challenge to rehabilitation strategies", Stroke, 26, pp.838~842 (1995)
- Yates JS, "Falls in community-dwelling stroke survivors: an accumulated impairments model", J Rehabil Res Dev, 39, pp.385~394 (2002)
- Blum L, "Usefulness of the Berg Balance Scale in stroke rehabilitation: a systematic review", Phys Ther, 88, pp.559~566 (2008)
- Stevenson TJ, "Detecting change in patients with stroke using the Berg Balance Scale", Aust J Physiother, 47, pp.29~38 (2001)
- Mansfield A, "Determinants and consequences for standing balance of spontaneous weight-bearing on the paretic side among individuals with chronic stroke", Gait Posture, 38, pp.428~432 (2013)
- Chen HY, "Independent control of force and timing symmetry in dynamic standing balance:implications for rehabilitation of hemiparetic stroke patients", Hum Mov Sci, 31, pp.1660~1669 (2012)
- Oken O, "Spatio-temporal and kinematic asymmetry ratio in subgroups of patients with stroke", Eur J Phys Rehabil Med, 44, pp.127~132 (2008)
- Garland SJ, "Recovery of standing balance and health-related quality of life after mild or moderately severe stroke", Arch Phys Med Rehabil, 88, pp.218~227 (2007)
- Marigold DS, "The relationship of asymmetric weight-bearing with postural sway and visual reliance in stroke", Gait Posture, 23, pp.249~255 (2006)
- Peurala SH, "Postural instability in patients with chronic stroke", Restor Neurol Neurosci, 25, pp.101~108 (2007)
- Pereira LC, "Relationships between body symmetry during weight-bearing and functional reach among chronic hemiparetic patients", Rev Bras Fisioter, 14, pp.229~266 (2010)
- Sackley CM, "Falls, sway, and symmetry of weightbearing after stroke", Int Disabil Stud, 13, pp.1~4 (1991)
- Bronstein AM, "Automatic control of postural sway by visual motion parallax", Exp Brain Res, 113, pp.243~248 (1997)
- Marigold DS, "Contribution of muscle strength and integration of afferent input to postural instability in persons with stroke", Neurorehabil Neural Repair, 18, pp.222~229 (2004)
- Geurts AC, "Intrasubject variability of selected force-platform parameters in the quantification of postural control", Arch Phys Med Rehabil, 74, pp.1144~1150 (1993)
- Lafond D, "Intrasession reliability of center of pressure measures of postural steadiness in healthy elderly people", Arch Phys Med Rehabil, 85, pp.896~901 (2004)
- de Haart M, "Recovery of standing balance in postacute stroke patients: a rehabilitation cohort study", Arch Phys Med Rehabil, 85, pp.886~895 (2004)
- Mizrahi J, "Postural stability in stroke patients: vectorial expression of asymmetry, sway activity and relative sequence of reactive forces", Med Biol Eng Comput, 27, pp.181~190 (1989)
- Barra J, "Asymmetric standing posture after stroke is related to a biased egocentric coordinate system", Neurology, 72, pp.1582~1587 (2009)
- Chien CW, "A comparison of psychometric properties of the smart balance master system and the postural assessment scale for stroke in people who have had mild stroke", Arch Phys Med Rehabil, 88, pp.374~380 (2007)
- Liston RA, "Reliability and validity of measures obtained from stroke patients using the Balance Master", Arch Phys Med Rehabil, 77, pp.425~430 (1996)
- Di Fabio RP, "Relationship of sensory organization to balance function in patients with hemiplegia", Phys Ther, 70, pp.542~548 (1990)
- Robin X, "pROC: an open-source package for R and S+ to analyze and compare ROC curves", BMC Bioinformatics, 12, pp.77~ (2011)
- Ashburn A, "Predicting people with stroke at risk of falls", Age Ageing, 37, pp.270~276 (2008)
- Baetens T, "Prediction of falling among stroke patients in rehabilitation", J Rehabil Med, 43, pp.876~883 (2011)
- Mansfield A, "Clinical correlates of between-limb synchronization of standing balance control and falls during inpatient stroke rehabilitation", Neurorehabil Neural Repair, 26, pp.627~635 (2012)
- Maki BE, "A prospective study of postural balance and risk of falling in an ambulatory and independent elderly population", J Gerontol, 49, pp.M72~84 (1994)
