Gait asymmetry, ankle spasticity, and depression as independent predictors of falls in ambulatory stroke patients
Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed. This study was a prospective study of 112 inpatien...
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| description | Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed.
This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses. The outcome variable was the number of accidental falls during the 6-month follow-up period after baseline measurements.
The non-faller group exhibited significantly better walking velocity and FIM scale compared to the faller group (P < .001). The faller group exhibited higher levels of spasticity in the affected limbs, asymmetry of gait parameters in single support (P < .001), double support (P = .027), and step time (P = .003), and lower stability of center of gravity in the medial-lateral direction (P = .008). Psychological assessments revealed that the faller group exhibited more severe depression and lower confidence without falling. A multivariate logistic regression model identified three independent predictors of falls with high sensitivity (82.6%) and specificity (86.5%): the asymmetry ratio of single support [adjusted odds ratio, aOR = 2.2, 95% CI (1.2-3.8)], the level of spasticity in the gastrocnemius [aOR = 3.2 (1.4-7.3)], and the degree of depression [aOR = 1.4 (1.2-1.8)].
This study revealed depression, in additional to gait asymmetry and spasticity, as another independent factor for predicting falls. These results suggest that appropriate gait training, reduction of ankle spasticity, and aggressive management of depression may be critical to prevent falls in stroke patients. |
| doi_str_mv | 10.1371/journal.pone.0177136 |
| format | Article |
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This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses. The outcome variable was the number of accidental falls during the 6-month follow-up period after baseline measurements.
The non-faller group exhibited significantly better walking velocity and FIM scale compared to the faller group (P < .001). The faller group exhibited higher levels of spasticity in the affected limbs, asymmetry of gait parameters in single support (P < .001), double support (P = .027), and step time (P = .003), and lower stability of center of gravity in the medial-lateral direction (P = .008). Psychological assessments revealed that the faller group exhibited more severe depression and lower confidence without falling. A multivariate logistic regression model identified three independent predictors of falls with high sensitivity (82.6%) and specificity (86.5%): the asymmetry ratio of single support [adjusted odds ratio, aOR = 2.2, 95% CI (1.2-3.8)], the level of spasticity in the gastrocnemius [aOR = 3.2 (1.4-7.3)], and the degree of depression [aOR = 1.4 (1.2-1.8)].
This study revealed depression, in additional to gait asymmetry and spasticity, as another independent factor for predicting falls. These results suggest that appropriate gait training, reduction of ankle spasticity, and aggressive management of depression may be critical to prevent falls in stroke patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0177136</identifier><identifier>PMID: 28542281</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accidental Falls ; Aged ; Aged, 80 and over ; Analysis ; Ankle ; Ankle - physiopathology ; Assessments ; Asymmetry ; Balance ; Biology and Life Sciences ; Biomechanical Phenomena ; Biomedical engineering ; Center of gravity ; Cognition ; Depression (Mood disorder) ; Depression - complications ; Depression - physiopathology ; Engineering ; Falling ; Falls ; Fear ; Female ; Follow-Up Studies ; Gait ; Gait - physiology ; Health aspects ; Hospitals ; Humans ; Lateral stability ; Limbs ; Male ; Mathematical models ; Medicine ; Medicine and Health Sciences ; Mental depression ; Middle Aged ; Muscle Spasticity - complications ; Muscle Spasticity - diagnosis ; Muscle Spasticity - physiopathology ; Nursing homes ; Patients ; Physical Sciences ; Physiology ; Postural Balance ; Prognosis ; Prospective Studies ; Psychological assessment ; Regression analysis ; Rehabilitation ; Research and Analysis Methods ; Risk analysis ; Risk Factors ; Sensitivity ; Spasticity ; Stroke ; Stroke - complications ; Stroke - diagnosis ; Stroke - physiopathology ; Stroke - psychology ; Stroke patients ; Stroke Rehabilitation ; Studies ; Velocity ; Walking</subject><ispartof>PloS one, 2017-05, Vol.12 (5), p.e0177136-e0177136</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><rights>2017 Wei et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2017 Wei et al 2017 Wei et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c758t-661652c8edd665649db0533415b676f4c8d17d3790241cce257dc2c4b6d1099f3</citedby><cites>FETCH-LOGICAL-c758t-661652c8edd665649db0533415b676f4c8d17d3790241cce257dc2c4b6d1099f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441600/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5441600/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28542281$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wei, Ta-Sen</creatorcontrib><creatorcontrib>Liu, Peng-Ta</creatorcontrib><creatorcontrib>Chang, Liang-Wey</creatorcontrib><creatorcontrib>Liu, Sen-Yung</creatorcontrib><title>Gait asymmetry, ankle spasticity, and depression as independent predictors of falls in ambulatory stroke patients</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed.
This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses. The outcome variable was the number of accidental falls during the 6-month follow-up period after baseline measurements.
The non-faller group exhibited significantly better walking velocity and FIM scale compared to the faller group (P < .001). The faller group exhibited higher levels of spasticity in the affected limbs, asymmetry of gait parameters in single support (P < .001), double support (P = .027), and step time (P = .003), and lower stability of center of gravity in the medial-lateral direction (P = .008). Psychological assessments revealed that the faller group exhibited more severe depression and lower confidence without falling. A multivariate logistic regression model identified three independent predictors of falls with high sensitivity (82.6%) and specificity (86.5%): the asymmetry ratio of single support [adjusted odds ratio, aOR = 2.2, 95% CI (1.2-3.8)], the level of spasticity in the gastrocnemius [aOR = 3.2 (1.4-7.3)], and the degree of depression [aOR = 1.4 (1.2-1.8)].
This study revealed depression, in additional to gait asymmetry and spasticity, as another independent factor for predicting falls. These results suggest that appropriate gait training, reduction of ankle spasticity, and aggressive management of depression may be critical to prevent falls in stroke patients.</description><subject>Accidental Falls</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analysis</subject><subject>Ankle</subject><subject>Ankle - physiopathology</subject><subject>Assessments</subject><subject>Asymmetry</subject><subject>Balance</subject><subject>Biology and Life Sciences</subject><subject>Biomechanical Phenomena</subject><subject>Biomedical engineering</subject><subject>Center of gravity</subject><subject>Cognition</subject><subject>Depression (Mood disorder)</subject><subject>Depression - complications</subject><subject>Depression - physiopathology</subject><subject>Engineering</subject><subject>Falling</subject><subject>Falls</subject><subject>Fear</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Gait</subject><subject>Gait - physiology</subject><subject>Health aspects</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Lateral stability</subject><subject>Limbs</subject><subject>Male</subject><subject>Mathematical models</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Mental depression</subject><subject>Middle Aged</subject><subject>Muscle Spasticity - complications</subject><subject>Muscle Spasticity - diagnosis</subject><subject>Muscle Spasticity - physiopathology</subject><subject>Nursing homes</subject><subject>Patients</subject><subject>Physical Sciences</subject><subject>Physiology</subject><subject>Postural Balance</subject><subject>Prognosis</subject><subject>Prospective Studies</subject><subject>Psychological assessment</subject><subject>Regression analysis</subject><subject>Rehabilitation</subject><subject>Research and Analysis Methods</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Sensitivity</subject><subject>Spasticity</subject><subject>Stroke</subject><subject>Stroke - complications</subject><subject>Stroke - diagnosis</subject><subject>Stroke - physiopathology</subject><subject>Stroke - psychology</subject><subject>Stroke patients</subject><subject>Stroke Rehabilitation</subject><subject>Studies</subject><subject>Velocity</subject><subject>Walking</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNqNk1uL1DAUx4so7rr6DUQLgig4Y25NmxdhWXQdWFjw9hrSJJ3JbNp0k1Scb286012msg9SSNuT3_mfS3Ky7CUES4hL-HHrBt8Ju-xdp5cAliXE9FF2ChlGC4oAfnz0fZI9C2ELQIErSp9mJ6gqCEIVPM1uL4WJuQi7ttXR7z7koruxOg-9CNFIE_cWlSvdex2CcV1ic9Olf52WLubJroyMzofcNXkjrB33c9HWgxXJvMtD9O5G572IJjmE59mTRAX9YnqfZT-_fP5x8XVxdX25uji_WsiyqOKCUkgLJCutFKUFJUzVKX1MYFHTkjZEVgqWCpcMIAKl1KgolUSS1FRBwFiDz7LXB93eusCnbgUOWeoVJJigRKwOhHJiy3tvWuF33AnD9wbn11z41AWreQOUYgUWtCkLwkTDFMSgBDWtGljSGiatT1O0oW61kqlSL-xMdL7TmQ1fu9-8IARSAJLAu0nAu9tBh8hbE6S2VnTaDfu8MaSMVGPeb_5BH65uotYiFWC6xqW4chTl54ShFBOxMe_lA1R6lG6NTFerMck-c3g_c0hM1H_iWgwh8NX3b__PXv-as2-P2I0WNm6Cs0NMdy7MQXIApXcheN3cNxkCPk7GXTf4OBl8mozk9ur4gO6d7kYB_wUJkQj5</recordid><startdate>20170523</startdate><enddate>20170523</enddate><creator>Wei, Ta-Sen</creator><creator>Liu, Peng-Ta</creator><creator>Chang, Liang-Wey</creator><creator>Liu, Sen-Yung</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><scope>DOA</scope></search><sort><creationdate>20170523</creationdate><title>Gait asymmetry, ankle spasticity, and depression as independent predictors of falls in ambulatory stroke patients</title><author>Wei, Ta-Sen ; Liu, Peng-Ta ; Chang, Liang-Wey ; Liu, Sen-Yung</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-661652c8edd665649db0533415b676f4c8d17d3790241cce257dc2c4b6d1099f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Accidental Falls</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analysis</topic><topic>Ankle</topic><topic>Ankle - physiopathology</topic><topic>Assessments</topic><topic>Asymmetry</topic><topic>Balance</topic><topic>Biology and Life Sciences</topic><topic>Biomechanical Phenomena</topic><topic>Biomedical engineering</topic><topic>Center of gravity</topic><topic>Cognition</topic><topic>Depression (Mood disorder)</topic><topic>Depression - complications</topic><topic>Depression - physiopathology</topic><topic>Engineering</topic><topic>Falling</topic><topic>Falls</topic><topic>Fear</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Gait</topic><topic>Gait - physiology</topic><topic>Health aspects</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Lateral stability</topic><topic>Limbs</topic><topic>Male</topic><topic>Mathematical models</topic><topic>Medicine</topic><topic>Medicine and Health Sciences</topic><topic>Mental depression</topic><topic>Middle Aged</topic><topic>Muscle Spasticity - complications</topic><topic>Muscle Spasticity - diagnosis</topic><topic>Muscle Spasticity - physiopathology</topic><topic>Nursing homes</topic><topic>Patients</topic><topic>Physical Sciences</topic><topic>Physiology</topic><topic>Postural Balance</topic><topic>Prognosis</topic><topic>Prospective Studies</topic><topic>Psychological assessment</topic><topic>Regression analysis</topic><topic>Rehabilitation</topic><topic>Research and Analysis Methods</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Sensitivity</topic><topic>Spasticity</topic><topic>Stroke</topic><topic>Stroke - complications</topic><topic>Stroke - diagnosis</topic><topic>Stroke - physiopathology</topic><topic>Stroke - psychology</topic><topic>Stroke patients</topic><topic>Stroke Rehabilitation</topic><topic>Studies</topic><topic>Velocity</topic><topic>Walking</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wei, Ta-Sen</creatorcontrib><creatorcontrib>Liu, Peng-Ta</creatorcontrib><creatorcontrib>Chang, Liang-Wey</creatorcontrib><creatorcontrib>Liu, Sen-Yung</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Gale In Context: Opposing Viewpoints</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological & Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science & Engineering Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>Agricultural & Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Materials Science Database</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Meteorological & Geoastrophysical Abstracts - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wei, Ta-Sen</au><au>Liu, Peng-Ta</au><au>Chang, Liang-Wey</au><au>Liu, Sen-Yung</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Gait asymmetry, ankle spasticity, and depression as independent predictors of falls in ambulatory stroke patients</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2017-05-23</date><risdate>2017</risdate><volume>12</volume><issue>5</issue><spage>e0177136</spage><epage>e0177136</epage><pages>e0177136-e0177136</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Falls are the leading cause of injury in stroke patients. However, the cause of a fall is complicated, and several types of risk factors are involved. Therefore, a comprehensive model to predict falls with high sensitivity and specificity is needed.
This study was a prospective study of 112 inpatients in a rehabilitation ward with follow-up interviews in patients' homes. Evaluations were performed 1 month after stroke and included the following factors: (1) status of cognition, depression, fear of fall and limb spasticity; (2) functional assessments [walking velocity and the Functional Independence Measure (FIM)]; and (3) objective, computerized gait and balance analyses. The outcome variable was the number of accidental falls during the 6-month follow-up period after baseline measurements.
The non-faller group exhibited significantly better walking velocity and FIM scale compared to the faller group (P < .001). The faller group exhibited higher levels of spasticity in the affected limbs, asymmetry of gait parameters in single support (P < .001), double support (P = .027), and step time (P = .003), and lower stability of center of gravity in the medial-lateral direction (P = .008). Psychological assessments revealed that the faller group exhibited more severe depression and lower confidence without falling. A multivariate logistic regression model identified three independent predictors of falls with high sensitivity (82.6%) and specificity (86.5%): the asymmetry ratio of single support [adjusted odds ratio, aOR = 2.2, 95% CI (1.2-3.8)], the level of spasticity in the gastrocnemius [aOR = 3.2 (1.4-7.3)], and the degree of depression [aOR = 1.4 (1.2-1.8)].
This study revealed depression, in additional to gait asymmetry and spasticity, as another independent factor for predicting falls. These results suggest that appropriate gait training, reduction of ankle spasticity, and aggressive management of depression may be critical to prevent falls in stroke patients.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>28542281</pmid><doi>10.1371/journal.pone.0177136</doi><tpages>e0177136</tpages><oa>free_for_read</oa></addata></record> |
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| issn | 1932-6203 1932-6203 |
| language | eng |
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| source | Public Library of Science (PLoS) Journals Open Access; MEDLINE; DOAJ Directory of Open Access Journals; EZB-FREE-00999 freely available EZB journals; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Accidental Falls Aged Aged, 80 and over Analysis Ankle Ankle - physiopathology Assessments Asymmetry Balance Biology and Life Sciences Biomechanical Phenomena Biomedical engineering Center of gravity Cognition Depression (Mood disorder) Depression - complications Depression - physiopathology Engineering Falling Falls Fear Female Follow-Up Studies Gait Gait - physiology Health aspects Hospitals Humans Lateral stability Limbs Male Mathematical models Medicine Medicine and Health Sciences Mental depression Middle Aged Muscle Spasticity - complications Muscle Spasticity - diagnosis Muscle Spasticity - physiopathology Nursing homes Patients Physical Sciences Physiology Postural Balance Prognosis Prospective Studies Psychological assessment Regression analysis Rehabilitation Research and Analysis Methods Risk analysis Risk Factors Sensitivity Spasticity Stroke Stroke - complications Stroke - diagnosis Stroke - physiopathology Stroke - psychology Stroke patients Stroke Rehabilitation Studies Velocity Walking |
| title | Gait asymmetry, ankle spasticity, and depression as independent predictors of falls in ambulatory stroke patients |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T05%3A50%3A06IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Gait%20asymmetry,%20ankle%20spasticity,%20and%20depression%20as%20independent%20predictors%20of%20falls%20in%20ambulatory%20stroke%20patients&rft.jtitle=PloS%20one&rft.au=Wei,%20Ta-Sen&rft.date=2017-05-23&rft.volume=12&rft.issue=5&rft.spage=e0177136&rft.epage=e0177136&rft.pages=e0177136-e0177136&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0177136&rft_dat=%3Cgale_plos_%3EA492600291%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1901714342&rft_id=info:pmid/28542281&rft_galeid=A492600291&rft_doaj_id=oai_doaj_org_article_f0dd953a6f7549af9d13070b68f176b1&rfr_iscdi=true |