Article

Purpose To use a mixed method design to evaluate how clinicians judge falls in
stroke patients as a beneficial event, and to identify patient-specific
characteristics associated with beneficial falls. Methods The definition of
beneficial falls was based on interviews with six experienced clinicians in
stroke rehabilitation. Interview data were analyzed using the grounded theory
approach, with outcomes used to develop a checklist to judge falls as beneficial.
We subsequently used the checklist to identify falls sustained by patients in our
rehabilitation unit as beneficial events. The characteristics of beneficial
fallers were investigated in this retrospective study. Results According to
experienced clinicians, beneficial falls result from patient-specific factors and
level of independence. Beneficial falls are not associated with after-effects or
a diagnosis of cognitive impairment, do not result in physical injury and
post-fall syndrome, and do not alter the course of rehabilitation. These falls
are considered to enhance patients' self-awareness of their physical status and
abilities. Among the 123 stroke patients who experienced a fall in our study
group, 23 patients (18.7%) were identified as beneficial fallers according to our
checklist. The majority had a left hemiplegia and perceptual impairments, and
were at low risk of recurrent falls and made functional gains during
rehabilitation. Conclusions Based on our results, we created a 10-item checklist
to differentiate beneficial from adverse falls. This differentiation is important
to target fall prevention programs to adverse fallers in rehabilitation units.

Langue : ANGLAIS