Predictors of falls among right-hemisphere stroke patients in the rehabilitation setting.
The purpose of the study was to examine neuropsychological and general medical risk factors for falls among a high-risk patient group in an inpatient rehabilitation setting. The sample consisted of 32 nonambulatory males who had sustained a right-hemisphere stroke (R-CVA). The Fall Assessment Questionnaire (FAQ) was introduced as a measure of known risk factors for falls in an inpatient setting. Neuropsychological assessment included measures of attention, perceptual deficits, hemispatial neglect, and impulsivity. A predictive model generated using multiple regression found that the FAQ combined with a measure of behavioral impulsivity successfully predicted fall status in 78% to 81% of cases, depending upon the cutting score used (p < .003). R-CVA patients who fell were more impulsive (p < .001) and received higher FAQ scores (p < .001). Perceptual deficit as measured by the Rey-Osterreith Complex Figure and general inattention as measured by Digit Span (reverse) were associated with falls (p < .04); however, they did not add to the model predicting which of the R-CVA patients would fall. It was suggested that impulsivity may act as an important mediating factor in determining individual risk for fall.
Department of Psychology, Veterans Administration Medical Center, Long Beach, CA 90822.
L J
LJ
Rapport
J S
JS
Webster
K L
KL
Flemming
J W
JW
Lindberg
M C
MC
Godlewski
J E
JE
Brees
P S
PS
Abadee
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000368:Aged; D000704:Analysis of Variance; D002561:Cerebrovascular Disorders / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011930:Reaction Time; D012044:Regression Analysis; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology