Relationship between Self-Perceived Postural Limits and Falls among Hospitalized Stroke Patients

抄録

[Purpose] To investigate the relationship between errors in perceiving postural limits and falls in hospitalized hemiplegic patients. [Subjects] Sixty hemiplegic inpatients were included in this study. [Methods] Error in perceiving postural limits was defined as the difference between the estimated maximum reach and actual reach distances, and its relationship to falls during three months of hospitalization was investigated. The other measurements included Functional Ambulation Category, Brunnstrom's recovery stage, sensory disturbance, fear of falling, and the Japanese version of the Montgomery-Åsberg Depression Rating Scale (MADRS-J). [Results] For the multiple fall group, the error in estimated distance (EED) was significantly greater than that for the zero/single fall group (p<0.01). Logistic regression analysis showed that EED and MADRS-J scores were correlated with multiple falls. According to the receiver operating characteristic curve for EED, the cut-off value for the multiple fall group was 6.3 cm (sensitivity: 80%, specificity: 77.8%). Using this value, the likelihood ratio and risk ratio for multiple falls was 3.6 and 6.9 (95% confidence interval: 2.2-21.8), respectively. [Conclusion] These results suggest that assessing error in perceiving postural limits by EED of hemiplegic patients is one method for identifying individuals at high risk of fall.