Accidental falls among community-dwelling people with chronic stroke in Hong Kong

Abstract

Purpose. To investigate the association between demographics, strokespecific disabilities, fall-related self-efficacy, and fall history of people with chronic stroke living in the community in Hong Kong. Methods. A convenience sample of 112 community-dwelling adults with chronic stroke and mild-to-moderate disabilities who had been discharged from hospital for >1 year was recruited. Assessment consisted of 2 sessions. The first session comprised the Activity-Specific Balance Confidence Scale-Cantonese, a questionnaire on visual-spatial ability, and a questionnaire to collect demographic data, fall history, and circumstances of the last fall. The second session assessed residual stroke impairments (including balance, mobility, muscle power, and ankle spasticity at the paretic side) and functional assessments using the Modified Ashworth Scale, the Berg Balance Scale, the timed upand- go test, and the Chinese Frenchay Activities Index. Results. Of the 95 participants analysed, 26 had one fall and 24 had more than one fall in the preceding year; the prevalence of falls was 52.6%. 18 of the fallers had injuries and 8 needed medical attention. Of the 74 falls in the previous year, 43 occurred indoors and 31 occurred outdoors. The common activities preceding the fall were walking (n=12), transitioning body posture (n=9), and going up or down stairs (n=6). Participants who had support from domestic helpers and better balance were less likely to fall. Participants who had visual acuity impairments and were living in public housing were more likely to have multiple falls. In contrast, those who were living with spousal support and had better balance were less likely to have multiple falls. Conclusion. Fall is common in people with chronic stroke. Homebased or environmental interventions targeting modifiable risk factors should be considered in fall-prevention programmes.