By Karla Gale

NEW YORK (Reuters Health) May 30 - Falls are common and often result in injury requiring medical treatment during the 6-month period following a stroke, according to surveys among more than 1000 stroke survivors in New Zealand.

Stroke doubles the risk of falling once patients leave the hospital, lead author Dr. Ngaire Kerse of the University of Auckland told Reuters Health. "Fall prevention should be part of stroke rehabilitation," she added. "This paper emphasizes the need for fall prevention to be extended after discharge and into the community."

In a prospective, population-based study, Dr. Kerse and colleagues interviewed 1104 stroke survivors (mean age 71 years). According to their report in the June issue of Stroke, 407 patients (37%) reported having a fall in the 6 months since their stroke. Most falls occurred at home and indoors.

Among those who had fallen, 52% fell more than once, and 12% fell more than five times. More than one third (37%) suffered an injury that required medical treatment, and 8% sustained a fracture.

In multivariable analysis, independent predictors of falls were older age, a fall in the year prior to stroke, increased stroke severity, and symptoms of depression.

Risk factors associated with fall-related injury were female gender and New Zealand/European ethnicity. Protective factors were normal cognition and higher levels of activity.

"The use of an assistive device - such as walkers or canes -- did not contribute to the regression model relating risk to falls," Dr. Kerse noted.

"Our findings highlight the need for fall prevention interventions," the researcher continued. "For all older people, proven strategies involve mobility retraining (already a part of stroke rehab) and occupational therapy assessment and modification of hazard risk at home," such as ensuring appropriate lighting, removal of obstacles and installation of transfer rails.

Still, little is known regarding strategies that would be most beneficial to stroke patients. To bridge that gap, Dr. Kerse and her associates are planning a "fall prevention trial for patients post-stroke surviving and living in the community."

Stroke 2008;39:1890-1893.