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Stroke Survivors who Fall: An Exploratory Cross-Sectional Survey in Nigeria

Published online by Cambridge University Press:  08 June 2016

Grace Vincent-Onabajo Open the ORCID record for Grace Vincent-Onabajo [Opens in a new window] ,
Adamu Usman Gamawa ,
Mohammad Usman Ali ,
Fatima Kachalla Gujba  and
Mamman Ali Masta
Grace Vincent-Onabajo*
Affiliation:
Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
Adamu Usman Gamawa
Affiliation:
Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
Mohammad Usman Ali
Affiliation:
Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
Fatima Kachalla Gujba
Affiliation:
Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
Mamman Ali Masta
Affiliation:
Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
*
Address for correspondence: Dr Grace Vincent-Onabajo, Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria. E-mail: [email protected]
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Abstract

Background: Falls and fall-related injuries rank among the most common complications after stroke, and are characterised by high rates of morbidity and mortality. This study examined the proportion, and the socio-demographic and clinical characteristics of those who fell among stroke survivors attending physiotherapy facilities in selected hospitals in Nigeria.

Methods: Socio-demographic, clinical and falls data were obtained using a researcher-designed questionnaire while the modified Rankin scale (mRS) was used to assess functional ability of the participants. Descriptive statistics of frequencies, percentages, mean and standard deviation were used to summarise all data. Pearson's Chi square statistic was used to identify significant socio-demographic and clinical characteristics of those who fell.

Results: One hundred stroke survivors participated in the study with a majority of males (67%). Mean ± SD age of the stroke survivors was 55.97 ± 9.56 years (range = 33–85 years). Thirty-three (33%) stroke survivors fell within the 3 months prior to the study and a significant proportion were older (p < .001) and had more diminished functional ability (p < .001).

Conclusion: A considerable proportion of the stroke survivors fell, especially those in the older age-group and those with diminished functional ability. These findings suggest that improving functional ability after stroke may prevent falls while older stroke survivors would also require intensive falls prevention strategies to reduce their susceptibility to falls post stroke. Longitudinal studies on the incidence and frequency of falls among stroke survivors in Nigeria, and clinical trials on appropriate falls prevention strategies are however urgently required.

Keywords

Fallsstrokeagefunctional ability
Type
Themed articles on Stroke
Information
Brain Impairment , Volume 17 , Issue 2: Themed issue on Stroke , September 2016 , pp. 143 - 150
Copyright
Copyright © Australasian Society for the Study of Brain Impairment 2016 

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References

Adeloye, D. (2014). An estimate of the incidence and prevalence of stroke in Africa: A systematic review and meta-analysis. PLoS ONE, 9 (6), e100724.CrossRefGoogle Scholar
Allen, N.E., Schwarzel, A.K., & Canning, C.G. (2013). Recurrent falls in Parkinson's disease: A systematic review. Parkinson's Disease, Retrieved from http://dx.doi.org/10.1155/2013/906274.CrossRefGoogle ScholarPubMed
Ashburn, A., Hyndman, D., Picking, R., Yardley, L., & Harris, S. (2008). Predicting people with stroke at risk of falls. Age and Ageing, 37 (3), 270–276.CrossRefGoogle ScholarPubMed
Batchelor, F.A., Mackintosh, S.F., Said, C.M., & Hill, K.D. (2012). Falls after stoke. International Journal of Stroke, 7 (6), 482–490.CrossRefGoogle Scholar
Birabi, B.N., Oke, K.I., Dienye, P.O., & Okafor, U.C. (2012). Cost burden of post stroke condition in Nigeria: A pilot study. Global Journal of Health Science, 4 (6), 17–22.CrossRefGoogle ScholarPubMed
Campbell, A.J., Robertson, M.C., & Gardner, M.M. (1995). Elderly people who fall: Identifying and managing the causes. British Journal of Hospital Medicine, 54 (10), 520–523.Google ScholarPubMed
Connor, M.D., Walker, R., Modi, G., & Warlow, C.P. (2007). Burden of stroke in black populations in sub-Saharan Africa. The Lancet Neurology, 6 (3), 269–278.CrossRefGoogle ScholarPubMed
Cummings, S.R., & Melton, L.J. (2002). Osteoporosis I: Epidemiology and outcomes of osteoporotic fractures. The Lancet, 359 (9319), 1761–1767.CrossRefGoogle ScholarPubMed
Danesi, M., Okubadejo, N., & Ojini, F. (2007). Prevalence of stroke in an urban, mixed-income community in Lagos, Nigeria. Neuroepidemiology, 28 (4), 216–223.CrossRefGoogle Scholar
Dennis, M.S., Lo, K.M., McDowall, M., & West, T. (2002). Fractures after stroke. Frequency, types, and associations. Stroke, 33 (3), 728–734.CrossRefGoogle ScholarPubMed
Donoghue, O.A., Cronin, H., Savva, G.M., O'Reagan, C., & Kenny, R.A. (2013). Effects of fear of falling and activity and activity restriction on normal and dual task walking in community dwelling older adults. Gait and Posture, 38 (1), 120–124.CrossRefGoogle ScholarPubMed
Feigin, V.L., Barker-Collo, S., Parag, V., Senior, H., Lawas, C.M., Ratnasabapathy, Y.,. . . ASTRO Study Group. (2010). Auckland stroke outcomes study. Part 1: Gender, stroke types, ethnicity, and functional outcomes 5 years poststroke. Neurology, 75 (18), 1597–1607.CrossRefGoogle ScholarPubMed
Feigin, V.L., Forouzanfar, M.H., Krishnamurthi, R., Mensah, G.A., Connor, M., Bennet, D.A.,. . . Murray, C. (2014). Global and regional burden of stroke during 1990–2010: Findings from the global burden of disease study, 2010. Lancet, 383 (9913), 245–255.CrossRefGoogle ScholarPubMed
Feng, M., Zhang, J., Shen, H., Hu, H., & Cao, L. (2009). Predictors of prognosis for elderly patients with post-stroke hemiplegia experiencing hip fractures. Clinical Orthopaedics and Related Research, 467 (11), 2970–2978.CrossRefGoogle Scholar
Forster, A., & Young, J. (1995). Incidence and consequences of falls due to stroke: A systematic inquiry. British Medical Journal, 311 (6997), 83–86.CrossRefGoogle ScholarPubMed
Gillespie, L.D., Robertson, M.C., Gillespie, W.J., Sherrington, C., Gates, S., Clemson, L.M., & Lamb, S.E. (2012). Interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Review, 12, 9.Google Scholar
Gillis, A., & Macdonald, B. (2005). Deconditioning in the hospitalized elderly. Review article. Canadian Nurse, 101 (6), 16–20.Google Scholar
Hankey, G.J., Spiesser, J., Hakimi, Z., Bego, G., Carita, P., & Gabriel, S. (2007). Rate, degree, and predictors of recovery from disability following ischemic stroke. Neurology, 68 (19), 1583–1587.CrossRefGoogle ScholarPubMed
Homann, B., Plaschg, A., Grunder, M., Haubenhofer, A., Griedl, T., Ivanic, G.,. . . Homann, C.N. (2013). The impact of neurological disorders on the risk for falls in the community dwelling elderly: A case-controlled study. BMJ Open, 3 (11). doi:10.1136/bmjopen.2013-003367.CrossRefGoogle ScholarPubMed
Hyndman, D., Ashburn, A., & Stack, E. (2002). Fall events among people with stroke living in the community: Circumstances of falls and characteristics of falls. Archives of Physical Medicine and Rehabilitation, 83 (2), 165–170.CrossRefGoogle Scholar
Jørgensen, L., Engstad, T., & Jacobsen, B.K. (2002). Higher incidence of falls in long-term stroke survivors than in population controls. Depressive symptoms predict falls after stroke. Stroke, 33 (2), 542–547.CrossRefGoogle ScholarPubMed
Kerse, N., Parag, V., Feigin, V.L., Mc Naughton, H., Hackett, M.L., Bennett, D.A., . . . the Auckland Regional Community Stroke (ARCOS) Study Group. (2008). Falls after stroke. Results from the Auckland regional community stroke (ARCOS) study, 2002 to 2003. Stroke, 39 (6), 1890–1893.CrossRefGoogle ScholarPubMed
Komolafe, M. A., Ogunlade, O., & Komolafe, E. O. (2007). Stroke mortality in a teaching hospital in South Western Nigeria. Tropical Doctor 37 (3), 186–188.CrossRefGoogle Scholar
Mackintosh, S.F.H., Hill, K., Dodd, K.J., Goldie, P., & Culham, E. (2005). Falls and injury prevention should be part of every stroke rehabilitation plan. Clinical Rehabilitation, 19 (4), 441–451.CrossRefGoogle ScholarPubMed
Muir, S.W., Berg, K., Chesworth, B., Klar, N., & Speechley, M. (2010). Balance impairment as a risk factor for falls in community-dwelling older adults who are high functioning: A prospective study. Physical Therapy, 90 (3), 338–347.CrossRefGoogle ScholarPubMed
Mukherjee, D., & Patil, C.G. (2011). Epidemiology and the global burden of stroke. World Neurosurgery, 76 (6), S85–S90.CrossRefGoogle ScholarPubMed
Nyberg, L., & Gustafson, Y. (1995). Patient falls in stroke rehabilitation. A challenge to rehabilitation strategies. Stroke, 26 (5), 838–842.CrossRefGoogle ScholarPubMed
Olaleye, O., & Suddick, K. (2012). A study of perceived factors affecting patients’ participation in outpatient stroke physiotherapy. International Journal of Therapy and Rehabilitation, 19 (10), 581–590.CrossRefGoogle Scholar
Ramnemark, A., Nyberg, L., Borssén, B., Olsson, T. & Gustafson, Y. (1998). Fractures after stroke. Osteoporosis International, 8 (1), 92–95.CrossRefGoogle ScholarPubMed
Ramnemark, A., Nilsson, M., Borssén, B., & Gustafson, Y. (2000). Stroke, a major and increasing risk factor for femoral neck fracture. Stroke, 31 (7), 1572–1577 CrossRefGoogle Scholar
Rubenstein, L.Z. (2006). Falls in older people: Epidemiology, risk factors and strategies for prevention. Age and Ageing, 35 (Suppl. 2), ii37–ii47.CrossRefGoogle ScholarPubMed
Sanya, E.O., Desalu, O.O., Adepoju, F., Aderibigbe, S.A., Shittu, A., & Olaosebikan, O. (2015). Prevalence of stroke in three semi-urban communities in middlebelt of Nigeria; a door to door survey. The Pan African Medical Journal, 20, 33.CrossRefGoogle ScholarPubMed
Schmid, A.A., Arnold, S.E., Jones, V.A., Ritter, A.J., Sapp, S.A., & Van Puymbroeck, M. (2015). Fear of falling in people with chronic stroke. American Journal of Occupational Therapy, 69 (3), 6903350020p1–6903350020p5.CrossRefGoogle ScholarPubMed
Schmid, A.A., Van Puymbroeck, M., Knies, K., Spangler-Morris, C., Watts, K., Damush, T., & Williams, L.S. (2011). Fear of falling among people who have sustained a stroke: A 6-month longitudinal pilot study. American Journal of Occupational Therapy, 65 (2), 125–132.CrossRefGoogle ScholarPubMed
Sibolt, G., Curtze, S., Melkas, S., Pohjasvaara, T., Kaste, M., Karhunen, P.J.,. . .Erkinjuntti, T. (2014). White matter lesions are associated with hospital admissions because of hip-fractures and trauma after ischemic stroke. Stroke, 45 (10), 2948–2951.CrossRefGoogle ScholarPubMed
Stolze, H., Klebe, S., Zechlin, C., Baecker, C., Friege, L., & Deuschl, G. (2004). Falls in frequent neurological diseases - prevalence, risk factors and aetiology. Journal of Neurology, 251 (1), 79–84.CrossRefGoogle ScholarPubMed
Tilson, J.K., Wu, S.S., Cen, S.Y., Feng, Q., Rose, D.R., Behrman, A.L.,. . . Duncan, P.W. (2012). Characterizing and identifying risk for falls in the LEAPS study: a randomized clinical trial of interventions to improve walking poststroke. Stroke, 43 (2), 446–452.CrossRefGoogle ScholarPubMed
van Haastregt, J., Zijlstra, G.A., van Rossum, E., van Eijk, J.T., & Kempen, G.I. (2008). Feelings of anxiety and symptoms of depression in community-living older persons who avoid activity for fear of falling. American Journal of Geriatric Psychiatry, 16 (3), 186–193.CrossRefGoogle ScholarPubMed
Wolfe, C.D., Crichton, S.L., Heuschmann, P.U., Mckevitt, C.J., Toschke, A.M., Grieve, A.P., & Rudd, A.G. (2011). Estimates of outcomes up to ten years after stroke: Analysis from the prospective South London Stroke Register. PLoS Medicine, 8 (3), e101033.CrossRefGoogle ScholarPubMed
Wolfe, C.D., Taub, N.A., Woodrow, E.J., & Burney, P.G. (1991). Assessment of scales of disability and handicap for stroke patients. Stroke, 22 (10), 1242–1244.CrossRefGoogle ScholarPubMed
World Bank. (2014). Nigeria Economic Report. Nigeria Economic Report; no 2. Washington, DC: World Bank Group. http://documents.worldbank.org/curated/en/2014/07/19883231/nigeria-conomic-report-no-2 Google Scholar
World Health Organization. (2007). WHO global report on falls prevention in older age. Geneva, Switzerland: World Health Organization.Google Scholar
Yates, J.S., Lai, S.M., Duncan, P.W., & Studenski, S. (2002). Falls in community-dwelling stroke survivors: An accumulated impairment model. Journal of Rehabilitation Research and Development, 39 (3), 385–394.Google Scholar