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[Incidence, circumstances and consequences of falls in patients undergoing rehabilitation after a first stroke]
D Pérennou1, A El Fatimi, M Masmoudi
1Service de rééducation neurologique et Inserm ERM207, centre de médecine physique et réadaptation, CHU, 23, rue Gaffarel, 21079 Dijon cedex, France. dominic.perennou@chu-dijon.fr
Objectives:
To describe the incidence, circumstances, and consequences of falls in patients admitted in a rehabilitation ward after a stroke.
Methods:
Prospective monitoring of falls over four years in a neurological rehabilitation unit. Use of fall registry.
Inclusion Criteria:
age < 75 years, admission < 45 days after stroke onset, single stroke of 1 cerebral hemisphere (nonlacunar) or of the brain stem. Only falls due to loss of balance were considered; falls caused by a seizure or syncope were not considered.
Results:
Of 217 consecutive patients with the inclusion criteria, 34 had fallen at least once (15.7%) and 10 twice (4.1%). Fall incidence, defined as the number of falls per patient per day was 2.2 per thousand. Half of the patients fell the first three weeks after admission. Most falls involved getting to or from the wheelchair or the bed; 1 patient had recovered minimal postural abilities at the gym but was not independent. Traumatic lesions were noted in 13 patients: they were minor in nine and severe in four, including three fractures.
Conclusion:
Falls due to loss of balance are a major problem in patients undergoing rehabilitation after a stroke. Getting to and from wheelchairs in the bedroom and bathroom by patients who are not allowed to do so play a key role in many falls. Prevention programs should consider this information.