Relationship of balance and mobility to fall incidence in people with chronic stroke

Background and Purpose. People with stroke are at risk for falls. The purpose of this study was to estimate the strength of the relationship of balance and mobility to falls. Subjects. The participants were 99 community-dwelling people with chronic stroke. Methods. An interview was used to record fall history, and physical performance assessments were used to measure balance (Berg Balance Scale [BBS]) and mobility (gait speed). Results. No differences were found between subjects who fell once and subjects who did not fall or between subjects who fell more than once and subjects who did not fall. Neither balance nor mobility was able to explain falls in people with chronic stroke. Discussion and Conclusion. Clinicians should be cautious when using the BBS or gait speed to determine fall risk in this population. Falls occurred frequently during walking; it may be necessary to focus on reactive balance and environmental interaction when assessing individuals for risk of falls and devising fall prevention programs for individuals with chronic stroke. The authors' observations suggest that the prescription of 4-wheel walkers for individuals with a low BBS score (less than or equal to45) may be a mobility aid that could reduce the risk of falls.