Reducing Fall Risks: Importance of Balance Training and Fall Prevention After a Mild Stroke or TIA

Balance training and fall prevention can reduce the risks

People who have suffered a mild stroke or TIA are at a significantly greater risk of a subsequent fall than people who have not had a stroke. They also have more balance and walking problems, and they exercise less intensively. This is evident from research by Radboud university medical center. Balance training and fall prevention can reduce the risks.

In the Netherlands, 2% of the population lives with the consequences of a stroke. About 40,000 people suffer a first stroke every year, about half of whom experience a mild stroke. In addition, approximately 53,000 people suffer a TIA every year. In people with mild complaints, the hospital stay generally lasts less than three days and no permanent balance problems appear to occur. After a one-time return to an aftercare clinic, they are usually no longer seen by a healthcare provider.

Researchers from Radboudumc and TU Delft wanted to know whether this group really does not experience any consequences from a mild stroke or TIA, especially in the longer term. That is why they examined 70 people who had had a stroke at least six months earlier. They compared these with 47 people without stroke, the control group. They all came to the hospital for a balance and gait test. An activity meter then recorded the movements and activities of both groups for a week. Participants also kept track of any falls for a year.

The results show that the post-stroke group had more than twice the risk of a fall than the control group. These people also walked slower and were more likely to suffer from balance problems. Lead researcher Vivian Weerdesteyn, professor at the Rehabilitation Department of Radboud university medical center: ‘You cannot see with the naked eye that these people move differently, but the tests in the hospital showed minimal abnormalities. This was subsequently reflected in the data from the activity meter and fall calendar. A mild stroke or TIA also has an impact on balance, walking and the risk of falls.’

Predictor of a new fall
The increased risk of a fall was particularly striking. “We did not know until now that this group, which is quite large all in all, falls more often than people who have not had a mild stroke or TIA,” says Weerdesteyn. These patients generally disappear from the attention of healthcare providers because they have no obvious complaints. Weerdesteyn: ‘The participants in our study were still relatively young, in their early 60s. They resumed their daily lives after the event. Some are still working and are living life to the full. Yet these people have problems, we now see.’

That is why Weerdesteyn advocates more awareness, both among the population and among healthcare providers. Because previous research already showed that a history of falls is the greatest predictor of a new fall. ‘This also applies if the first fall did not lead to serious damage, such as broken bones or a concussion. A subsequent fall can lead to serious damage. And that is important, because we also know: the older someone is, the higher the risk that a fall will be serious. So if someone falls again ten years later, the damage is often greater.’

Fall prevention training
People can reduce the risk of a fall through fall prevention training. Weerdesteyn recommends this training to people who have suffered a mild stroke or TIA, even if they no longer have any obvious complaints. ‘People can improve these skills with training aimed at balance and walking ability. This significantly reduces the risk of a fall. And this also applies to a serious fall at a later date, which could, for example, end up in the emergency room.’

This article appeared in Neurorehabilitation and Neural Repair: Mild stroke, serious problems: limitations in balance and gait capacity and the impact on fall rate, and physical activity

Bron: Radboudumc

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2023-11-02 08:00:18
#stroke #TIA #risk #falling #doubled