What prevents falls after strokes? Study: Not much

NEW YORK (Reuters Health) - While most stroke survivors will suffer falls, strategies to prevent these dangerous events continue to fall short, suggests a new study out of Australia.

Up to three in four stroke survivors fall within six months of their stroke, and these falls can lead to serious injuries, including broken bones.

"Although research has shown that fall prevention programs including exercise are effective for older people, it was unclear whether these, or any other interventions, work for people with stroke," lead researcher Dr. Francis Batchelor of the University of Melbourne, in Australia, told Reuters Health by email.

So Batchelor and his colleagues carefully reviewed the relevant research to date and pooled together the results of 13 studies that enlisted a total of nearly 1,500 people.

The studies analyzed a wide range of interventions to prevent falls after strokes, from strength training to medications, report the researchers in the journal Stroke.

However, the only strategy their review found to be effective was vitamin D supplementation, and even that only worked for women in nursing homes and other institutions at least two years after they had suffered a stroke.

"The effectiveness of vitamin D in fall prevention in all people with stroke has not yet been determined," noted Batchelor.

Overall, the team was surprised to find so few quality trials addressing the common problem. Most of the studies were primarily designed to look at an outcome other than falls, and the majority used stand-alone interventions that may not have been effective enough for this high-risk group.

Batchelor noted that future trials should evaluate a multifaceted fall-reducing program for people with stroke.

He also recommended looking closer at the potential benefit of vitamin D supplementation on falls for both men and women, and in earlier stages after stroke.

For now, Batchelor's best advice for stroke survivors is to "consult a health professional who can assess and address their individual fall risk factors."

SOURCE: link.reuters.com/dax52n Stroke, online July 8, 2010.