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.
Rapport
L J
LJ
Department of Psychology, Veterans Administration Medical Center, Long Beach, CA 90822.
Webster
J S
JS
Flemming
K L
KL
Lindberg
J W
JW
Godlewski
M C
MC
Brees
J E
JE
Abadee
P S
PS
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