Turning duration and steps predict future falls in poststroke hemiplegic individuals: A preliminary cohort study

Area of Science:

• Neurology
• Biomechanics
• Rehabilitation Medicine

Background:

• Turning is a common activity associated with falls in stroke survivors.
• Post-stroke hemiplegia significantly impacts mobility and balance, increasing fall risk.
• Distinguishing fallers from non-fallers is crucial for targeted interventions.

Purpose of the Study:

• To determine if turning duration and steps differentiate past fallers from non-fallers in stroke patients.
• To assess the predictive value of turning parameters for future falls within one year.
• To identify specific turning thresholds indicative of increased fall risk.

Main Methods:

• Thirty post-stroke hemiplegia patients performed a 180° walking-turn task.
• Turning performance was measured using inertial sensors (Physilog).
• Data collected included turn duration, number of steps, and retrospective/prospective fall history.

Main Results:

• No significant differences in turn duration or steps were found between retrospective fallers and non-fallers.
• Prospective fallers exhibited significantly longer turn durations and more steps compared to non-fallers.
• A turn duration >4 seconds (AUC=0.75) and >7 steps (AUC=0.73) accurately predicted future falls.

Conclusions:

• Turning duration and steps cannot distinguish past fallers but can predict future falls in stroke patients.
• Exceeding 4 seconds or 7 steps during a 180° turn indicates a heightened risk of falling.
• These metrics offer a valuable tool for identifying high-risk stroke survivors for fall prevention strategies.