Patient falls in stroke rehabilitation. A challenge to rehabilitation strategies.

Abstract

The risk of falls is very high among stroke patients, and falling is a major complication in stroke rehabilitation. This study aimed to investigate the incidence, characteristics, and consequences of falls in an inpatient stroke rehabilitation setting. One hundred sixty-one patients consecutively admitted to a geriatric stroke rehabilitation unit were studied. Falls that occurred during their rehabilitation stay were prospectively registered and analyzed. Sixty-two of the patients (39%) suffered falls. The total number of falls was 153, which corresponds to an incidence rate of 159 falls per 10,000 patient-days. Most falls occurred during transfers or from sitting in a wheelchair or on some other kind of furniture. Seventeen falls (11%) were classified as the result of extrinsic mechanisms, 49 (32%) were intrinsic falls, 39 (25%) occurred in a nonbipedal position (while sitting or lying), and 48 falls (31%) remained unclassified. No injury was observed in 109 of 153 incidents (71%), whereas 6 falls (4%) involved fractures or other serious injury. Since falls are so frequent, they must be considered a significant problem in stroke rehabilitation. Fall prevention strategies should therefore be developed and included in rehabilitation programs.