The association of balance capacity and falls self-efficacy with history of falling in community-dwelling people with chronic stroke

Beliz Belgen, Marianne Beninato, Patricia E Sullivan, Khushnum Narielwalla
Archives of Physical Medicine and Rehabilitation 2006, 87 (4): 554-61

OBJECTIVES: To describe the frequency of falls; to relate capacity-based and self-efficacy measures to fall history; and to determine to what extent capacity-based and self-efficacy measures are explained by subject characteristics and stroke impairments.

DESIGN: Cross-sectional.

SETTING: Community.

PARTICIPANTS: Convenience sample of 50 people with chronic stroke.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Fall history, Falls Efficacy Scale-Swedish Version, fear of falling, and the mood subscore of the Stroke Impact Scale. Balance, strength, and functional mobility were measured using the Berg Balance Scale, timed sit to stand, and Timed Up & Go, respectively.

RESULTS: Falls were reported by 40% (n=20) of subjects; 22% (n=11) reported multiple falls. Subjects with fall history had more fear of falling (relative risk [RR], 2.4; 95% confidence interval [CI], 1.1-4.9), had less falls-related self-efficacy (P=.04), and more depressive symptoms (P=.02) than nonfallers. Subjects with multiple fall history had poorer balance (P=.02), more fear of falling (RR=5.6; 95% CI, 1.3-23), and used a greater number of medications (P=.04) than non- and 1-time fallers. Strength partially explained balance, mobility, and falls-related self-efficacy.

CONCLUSIONS: Balance and falls-related self-efficacy are associated with fall history and should be addressed in people with chronic stroke.

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