Impaired Reactive Stepping Among Patients Ready for Discharge From Inpatient Stroke

Background. Individuals with stroke are at increased risk for falls soon after hospital discharge. The ability to react to a balance perturbation, specifically with a rapid step, is critical to maintain balance and prevent falls. Objective. The purpose of the study was to determine the prevalence of impaired reactive stepping responses in an ambulatory group of patients with stroke who were preparing for discharge from inpatient rehabilitation and the relationship to patient performance on commonly used clinical measures of balance, mobility, and lower limb impairment. Design. This study was a retrospective analysis of patient admissions over a 3-year period. Methods. Charts were reviewed for patients who, at time of discharge, had completed a perturbation-evoked reactive stepping assessment. Results. Ninety-nine (71%) of 139 patients had impaired stepping reactions char-acterized by the need for assistance, an inability to step with either lower limb, or the need for multiple-step responses. There was a statistically significant difference i