Risk of falling during the 360º turning task in stroke patients

Abstract

Introduction: Changes in direction and turning while standing are common daily activities. Falls associated with turning is common in stroke survivors [1], likely because persistent impairments in strength, balance, postural control, gait patterns and coordination will affect their ability to turn safely. Previous studies have demonstrated, that fall injuries during turning tasks are eight times more common than during walking straight forward [2] and the incidence of falls in stroke survivors is more frequent toward the paretic side [3]. It is possible that differences between turning performances towards the paretic and non-paretic sides could be related to variables, such as balance, time of performance and number of steps [4,5]. Consequently, turning should be assessed and retraining in rehabilitation program. The objectives of this study was to analyze the risk of falling in 360º turning task in patients with stroke and the correlation of the 360º turning task with other measures of balance and risk of falling. Materials and methods: Eleven patients with ischemic stroke (mean age 68.78 ± 9.67 years, seven male and four female), eight with left paresis and three with right paresis. In all patients the balance and the risk of falls was assessed by the Berg Balance Scale (BBS) and Timed Up and Go test (TUGT). Turn performance was evaluated using the time and number of steps required to complete a 360° standing turn, and was evaluated for turns toward the paretic side and the non-paretic side. Each patient performed 3 trials in each direction and the average of the 3 trials was used for data analysis. All participants gave their written informed consent prior to inclusion in the investigation. This study follows all the principles of the Declaration of Helsinki. Results: We meet negative correlation between TUGT and the BBS (r = −0.694; p = 0.018), and positive correlations between TUGT and the Turn 360º to paretic side (time) (r = 0.733; p = 0.025), TUGT and the Turn 360º to non-paretic side (time) (r = 0.733; p = 0.025), TUGT and the Turn 360º to paretic side (steps) (r = 0.717; p = 0.030), TUGT and the Turn 360º to non-paretic side (steps) (r = 0.750; p = 0.020). The time needed for turns and the number of steps were similar for turns to the paretic and non-paretic sides. Discussion and conclusions: According to the results we can say that our sample has a risk of falling in 360º Turn, but there was no differences between the 360º turn for the paretic side or nonparetic side.