Post-stroke hip fractures

 Those post-stroke are at risk for both falls and the development of osteoporosis of

the hemiparietic limb, consequently, increasing risk for hip fractures [58]. Ramnemark

and colleagues observed hip fracture incidence in 1139 post-stroke individuals [171]. One

hundred and twenty participants sustained 154 fractures, 84% of all fractures were

secondary to an accidental fall. Hip fractures accounted for 70 (45%) of all recorded

fractures and most affected the paretic side. A four-fold increase of hip fracture was

demonstrated in this post-stroke population.

 Ramnemark, et al. completed an additional study examining those sustaining a

femoral neck fracture [172]. Short-term outcomes and mortality were compared for those

with and without a history of stroke. In total, 27.4% participants had sustained a stroke

prior to the hip fracture. Additionally, the majority of hip fractures occurred to the

hemiparietic limb and survival rates were reduced for these patients.

Fear of Falling After Stroke

Post-stroke balance confidence

 Currently, there is little research regarding the prevalence of fear of falling

development in the post-stroke population. At this time, the only work related to post-

stroke fear of falling has been completed to validate fear of falling assessments for the

post-stroke population [173-175]. The researchers have indicated that those who have

sustained a stroke are likely to exhibit lower falls confidence while performing activities,

thus demonstrated increased fear of falling.

 Decreased falls confidence, or falls efficacy, is based on Bandura's theory of self-

efficacy [176]. Those with low self-efficacy for a particular activity will tend to avoid

that activity. In contrast, those with high self-efficacy will initiate the activity with