This project has been generously funded, by a grant from the Ontario Ministry of Health and Long-Term Care, administered and supported by the Ontario Stroke Network. The views expressed do not necessarily reflect those of the Ministry or the Ontario Stroke Network.

Authors: Mansfield A, Wong JS, McIlroy WE, Biasin L, Brunton K, Bayley M, Inness EL.
Do measures of reactive balance control predict falls in people with stroke returning to the community? 
Physiotherapy (in press)

1. What are your main findings?

After you lose your balance, you execute reactions like swaying at your hips, taking a step, or reaching for something, to prevent yourself from falling to the floor. For many people with stroke, these balance reactions might be impaired. We measured control of balance reactions in people with stroke at discharge from in-patient rehabilitation and those with greater impairment of reactive balance control were more likely to fall after discharge home.

2. What is new about your research?

While our findings might seem intuitive, we are the first to draw a direct link between control of balance reactions and risk of falling in daily life after stroke. When other researchers and physiotherapists measure balance control, they usually only measure how well a person is able to stay stable during various movements, like walking or rising from a chair. Few measure the ability to react to instability or loss of balance.

3. Can you explain your methodology?

We recruited people with stroke at discharge from in-patient rehabilitation. We measured ability to respond to small losses of balance when standing still and walking, and stepping reactions following a large loss of balance. Participants were asked to record and report any falls they experienced for 6 months after discharge home. We used a statistical model to determine if our measures of balance reactions predicted falls after discharge.

4. What policy recommendations do your findings suggest?

These findings suggest that measuring control of balance reactions is important is physiotherapy practice for informing physiotherapists about the effect of stroke on balance control and risk of falling. It is also possible that training programs that improve the control of balance reactions could help to prevent falls after stroke.

5. Do your findings contradict any views or sources? If so, which ones?

To our knowledge, these findings to not contradict others.

6. How is your research meaningful for the ordinary person?

This research suggests that assessments and exercise to reduce falls should not only focus on a person’s ability to maintain balance but also on their ability to respond to a loss of balance.