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

"Stops walking when talking" as a predictor of falls in people with stroke living in the community
"Stops walking when talking" as a predictor of falls in people with stroke living in the community
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.
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, verbal behavior, walking
0022-3050
994 - 997
Hyndman, D.
6b6c65d5-1d03-4a13-9db8-1342cd43f352
Ashburn, A.
818b9ce8-f025-429e-9532-43ee4fd5f991
Hyndman, D.
6b6c65d5-1d03-4a13-9db8-1342cd43f352
Ashburn, A.
818b9ce8-f025-429e-9532-43ee4fd5f991

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).

Record type: Article

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.

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Published date: 1 July 2004
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, verbal behavior, walking

Identifiers

Local EPrints ID: 17921
URI: http://eprints.soton.ac.uk/id/eprint/17921
ISSN: 0022-3050
PURE UUID: 045ea6d4-53da-46e5-8a65-e0f9d1677918
ORCID for D. Hyndman: ORCID iD orcid.org/0000-0003-4449-1414

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Date deposited: 18 Nov 2005
Last modified: 16 Mar 2024 03:31

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Author: D. Hyndman ORCID iD
Author: A. Ashburn

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