"Stops walking when talking" as a predictor of falls in people with stroke living in the community


Hyndman, D. and Ashburn, A. (2004) "Stops walking when talking" as a predictor of falls in people with stroke living in the community. Journal of Neurology Neurosurgery and Psychiatry, 75, (7), 994 - 997. (doi:10.1136/jnnp.2003.016014).

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Original Publication URL: http://dx.doi.org/10.1136/jnnp.2003.016014

Description/Abstract

OBJECTIVE: To test "Stops walking when talking" (SWWT) as a predictor of falls among people with stroke living in the community.

METHODS: People with stroke were identified through hospital records. Mobility, ADL (activities of daily living) ability, mental state, mood, and SWWT were assessed in a single session. Participants were followed prospectively for six months, using falls diaries and regular telephone calls.

RESULTS: Sixty three participants (36 men, 27 women mean (SD) age 68.4 (10.6)) were recruited. Four subjects had a brainstem lesion, 30 had right hemisphere, and 29 left hemisphere infarctions. Mean time since onset of stroke was 20 months (range 2-72). Twenty six subjects stopped walking when a conversation was started and 16 of them fell during the six month follow up period (11 experienced repeated falls). For all fallers (>or=1) the positive predictive value of SWWT was 62% (16/26), the negative predictive value 62% (23/37), specificity 70% (23/33) and sensitivity 53% (16/30). For repeat fallers (>or=2) the positive predictive value of SWWT was 42% (11/26), the negative predictive value 89% (33/37), specificity 69% (33/48) and sensitivity 73% (11/15). Those who stopped walking were significantly more disabled (p<0.001)-that is, they were more dependent in activities of daily living, had worse gross function as well as worse upper and lower limb function, and had depression (p = 0.012).

CONCLUSIONS: The specificity of the SWWT test was lower but sensitivity was higher than previously reported. Although the SWWT test was easy to use, its clinical usefulness as a single indicator of fall risk in identifying those community dwelling people with stroke most at risk of falls and in need of therapeutic intervention is questionable.

Item Type: Article
ISSNs: 0022-3050 (print)
Related URLs:
Keywords: accidental falls, activities of daily living, adult, aged, aged 80 and over, article, cerebrovascular accident, community, epidemiology, female, follow-up studies, health, human, male, middle aged, prospective studies, psychomotor performance, fall prediction, stroke, divided attention, community questionnaires, recurrence, rehabilitation, sensitivity and specificity, statistics and numerical data, stroke, verbal behavior, walking
Subjects: H Social Sciences > HT Communities. Classes. Races
R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
Divisions: University Structure - Pre August 2011 > Superseded (SOHPRS)
ePrint ID: 17921
Date Deposited: 18 Nov 2005
Last Modified: 27 Mar 2014 18:07
URI: http://eprints.soton.ac.uk/id/eprint/17921

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