The relationship between the risk of falls and perceived balance in patients with chronic stroke in Johannesburg

Morgan, Amy Jessica
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Background: Stroke affects millions of people worldwide every year, and statistics show that there is a constant increase in the number of strokes occurring annually. There have been many research studies conducted looking at strokes, the physical and mental effects poststroke, balance and gait problems resulting from a stroke, falls in patients with a stroke and many other stroke-related issues; however, there has been very little research done on the perception of balance in patients with stroke and this dearth of research includes the relationship that this perceived balance has on the risk of falls in people with chronic stroke. There has also been very little research done in Johannesburg, South Africa, on people with stroke and this is the first study to be conducted regarding this topic. Main Objective: To determine the relationship between perceived balance and the risk of falls in patients, more than six months post-stroke within the Johannesburg region. Method: This study was a cross-sectional study, where 51 participants were assessed for their perceived balance, using the Activities-Specific Balance Confidence Scale (ABC scale), as well as for their risk of falling, by using the Dynamic Gait Index (DGI). In order to ensure that the participants were acceptable for the inclusion criteria, the Modified Mini Mental State Test (3Ms test) was used to screen for early signs of dementia. If participants had scored 50% or less for this test, they were excluded from the study. Results: In this study, 128 participants were recruited and only 51 took part in the study and met the inclusion criteria. From the results, we see that most of the study participants (n=26; 50.98%) had a higher level of perceived balance; the majority of the participants were found to be at risk of falling (n=36; 70.59%) and, with a p value of 0.002, there was a significant relationship between the risk of falls and perceived balance in the study population. Conclusion: There are many factors affecting the mobility and functionality of people with chronic stroke, which often result in an increased risk of falling. One factor that was found during this study was that perceived balance has an impact on actual balance scores, and that there is a significant relationship between the risk of falls and perceived balance among patients with chronic stroke.
A research report submitted fulfilment of the requirement for the degree Masters in Physiotherapy to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, 2020