Yuriko Watanabe

The objectives of this study were to assess the incidence of falls and fall consequences among patients who were discharged from inpatient stroke rehabilitation and to investigate the proportion of those who experienced a fear of falling following a fall. This was a follow-up postal questionnaire study of patients who were admitted to the rehabilitation ward in a local hospital (Japan) for stroke rehabilitation. Seventy-three patients who met inclusion criteria were sent questionnaires and 49 (67%) responded to the questionnaire. Thirty-three patients had at least one fall after discharge from the hospital and of these, four patients experienced fractures resulting from their falls. Twenty-nine patients developed a fear of falling. As falls are common in stroke survivors, more attention should be paid to falls after stroke during inpatient rehabilitation to prevent physical and emotional consequences of falls.

This paper looks at the proportion of patients who were already at risk of osteoporosis by measuring bone mineral density (BMD) and bone resorption, and to examine the relationships between BMD, age, gender and the levels of disability. 83 stroke patients were admitted to a rehabilitation ward in the National Nagasaki Hospital (Japan), between September 2000 and November 2001. The mean time from onset was 38.9 days. Of these, approximately 40% of patients had osteoporosis with a T-score of hip BMD of −2.5 SD or more below. Correlations were found between BMD (T-score), age and gender but not sides. Increased bone resorption was significant in female patients and it was also associated with age, the Brunnstrom motor recovery scores and the Barthel Index scores but not BMD at hips. This study suggests the need for attention to osteoporosis in sub-acute stroke patients. In addition to ordinary stroke rehabilitation, extra approaches/interventions will be necessary for such patients in order to prevent post stroke fracture.