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How do individuals with subacute stroke nearly fall during forward walking?

Yuji Osada1, Yosuke Kobayashi2, Tomo Osuka2

  • 1Department of Health and Welfare Tokushima Bunri University, Nishihamahoji-180, Yamashirocho, Tokushima 770-8514, Japan.

Gait & Posture
|April 11, 2025
PubMed
Summary

Individuals with stroke often fall backward during the single stance phase and forward during the swing phase. Understanding near-fall timing and direction aids in preventing falls in stroke survivors.

Keywords:
Accidental fallsGait analysisPostural balanceStroke

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Area of Science:

  • Biomechanics
  • Neurology
  • Rehabilitation Science

Background:

  • Falls in stroke survivors are difficult to study as they are often unwitnessed.
  • Kinematic analysis of gait using 3D motion capture can record near-fall events.
  • This study analyzed the relationship between the timing and direction of near falls in stroke patients.

Purpose of the Study:

  • To determine when and in which direction individuals with stroke experience near falls.
  • To identify specific gait phases associated with near-fall events.
  • To provide data for fall prevention strategies in stroke rehabilitation.

Main Methods:

  • Analyzed 67 near-fall trials from 67 individuals with stroke, selected from a larger dataset.
  • Classified near-fall timing into four gait phases: loading response (LR), single stance (SS), pre-swing (PS), and swing (SW) of the paretic limb.
  • Categorized near-fall direction into forward, backward, paretic side, and nonparetic side.

Main Results:

  • A significant association was found between near-fall timing and direction (p < 0.01).
  • Near falls backward occurred predominantly during the single stance (SS) phase.
  • Near falls forward were most common during the swing (SW) phase.

Conclusions:

  • Individuals with stroke tend to fall backward during the single stance phase and forward during the swing phase.
  • Understanding these specific near-fall patterns can inform targeted interventions.
  • This knowledge can assist caregivers in fall prevention for patients with subacute stroke.