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Vallen: Incidentie en risicofactoren bij patiënten met een beroerte

Een systematisch literatuuronderzoek

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Tijdschrift voor Gerontologie en Geriatrie

Samenvatting

Valincidenten komen veel voor bij patiënten na een beroerte. Deze literatuurstudie geeft een overzicht van de incidentie en de risicofactoren. Naast algemene valpreventie is het belangrijk rekening te houden met de specifieke problemen die gerelateerd zijn aan een hoger valrisico na een beroerte, zoals een depressie en cognitie stoornissen. Uit de geïncludeerde studies komt een aantal risicofactoren naar voren, zoals het zich verplaatsen van bed naar stoel, lopen naar badkamer en toilet, en de eerste dagen na het ontslag naar huis. Een keer gevallen zijn tijdens de ziekenhuisopname is een significante risicofactor voor latere valincidenten. Een meetinstrument om het risiconiveau betrouwbaar in te schatten is er (nog) niet. Scores op een aantal meetinstrumenten zoals de Barthel Index en de Timed-Up-and-Go test kunnen gebruikt worden als indicatoren voor een verhoogd risico. Na een val kan angst om te vallen ontstaan, waardoor het activiteitenniveau van patiënten vermindert. Het wordt aanbevolen om voor het ontslag naar huis patiënten een test af te nemen naar het vertrouwen in de balanshandhaving bij verschillende activiteiten. In de weinige studies waarin valincidenten een uitkomstmaat zijn, blijkt intensieve oefentherapie gericht op balansverbetering het aantal valincidenten te verminderen.

Falls: Incidence and risk factors after stroke. A systematic literature review

Falls are common after stroke. This article presents a literature review of the incidence and risk factors of falls and the consequences for professionals working with stroke patients. It is important to consider the specific problems after stroke. Depression and cognitive impairments were found to be risk factors for fall incidents after stroke. In the relevant literature many different risk factors and circumstances are described. When patients move from bed to chair, walk to the bathroom and the first few days after the patient is discharged to another setting, - all these circumstances showed high percentages of falling. A fall during hospital stay is a significant risk factor for future fall incidents. A reliable index to measure the fall risk is not (yet) available. But scores on the Barthel Index and the Timed-Up-and-Go test can be used as fall risk indicators. Fear of falling is an important complication after a fall and therefore it is recommended prior to discharge to inquire about the patient’s self efficacy in maintaining balance. Few intervention studies use the number of falls as an outcome measure. Exercising balance following a mass training protocol seems to diminish the risk of falling.

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  1. http://www.bsl.nl/shop/denkbeeld-0926-7182.html

    M. Rensink

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  1. M. Rensink
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  2. M. Schuurmans
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  3. E. Lindeman
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  4. T. B. Hafsteinsdóttir
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Correspondence to M. Rensink.

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onderzoeker, Lectoraat Verpleegkundige en Paramedische zorg voor mensen met chronische aandoeningen, Faculteit Gezondheidszorg, Hogeschool Utrecht

hoogleraar Revalidatie, Afdeling Revalidatie en Sportgeneeskunde, Rudolf Magnus Institute, UMC Utrecht en Revalidatiecentrum de Hoogstraat, Utrecht

lector, Lectoraat Verpleegkundige en Paramedische zorg voor mensen met chronische aandoeningen, Faculteit Gezondheidszorg, Hogeschool Utrecht

senior onderzoeker Divisie Hersenen, Rudolf Magnus Institute, UMC Utrecht; Lectoraat Verpleegkundige en Paramedische zorg voor mensen met chronische aandoeningen, Faculteit Gezondheidszorg, Hogeschool Utrecht en associate professor, Utrecht en Faculty of Nursing, University of Iceland, Reykjavik, IJsland.

Drs. Marijke Rensink, Lectoraat Verpleegkundige en Paramedische zorg voor mensen met chronische aandoeningen, Faculteit Gezondheidszorg, Hogeschool Utrecht, Bolognalaan 101 3584 CJ Utrecht. T: 030-2585100.

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Rensink, M., Schuurmans, M., Lindeman, E. et al. Vallen: Incidentie en risicofactoren bij patiënten met een beroerte. GEEG 40, 156–167 (2009). https://doi.org/10.1007/BF03079581

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