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Post-ischemic stroke rehabilitation is associated with a higher risk of fractures in older women: A population-based cohort study

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  • Huei Kai Huang
  • Shu Man Lin
  • Clement Shih Hsien Yang
  • Chung Chao Liang
  • Hung Yu Cheng

Abstract

Background: Rehabilitation can improve physical activity after stroke. However, patients may be more prone to falls and fractures because of balance and gait deficits. Few reports have studied the relationship between rehabilitation and subsequent fractures after ischemic stroke. Objective: To investigate whether post-stroke rehabilitation affects fracture risk. Methods: We conducted a population-based retrospective cohort study based on the Taiwan National Health Insurance Research Database. Patients with a newly diagnosed ischemic stroke between 2000 and 2012 were included. After propensity score matching, a total of 8,384 patients were enrolled. Half of the patients (4,192) received post-stroke rehabilitation within 1 month; the other half did not receive any post-stroke rehabilitation. Cox proportional hazards regression model was used to calculate hazard ratios (HRs) for fractures among patients with and without rehabilitation within 1 year after ischemic stroke. Patients were further stratified by sex and age (20–64 and ≥65 years). Results: Patients receiving post-stroke rehabilitation had a higher incidence of fracture (6.2 per 100 person-years) than those who did not (4.1 per 100 person-years) after adjustment for sociodemographic and coexisting medical conditions [HR = 1.53, 95% confidence interval (CI) = 1.25–1.87, p

Suggested Citation

  • Huei Kai Huang & Shu Man Lin & Clement Shih Hsien Yang & Chung Chao Liang & Hung Yu Cheng, 2017. "Post-ischemic stroke rehabilitation is associated with a higher risk of fractures in older women: A population-based cohort study," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-15, April.
    • Handle: RePEc:plo:pone00:0175825
    DOI: 10.1371/journal.pone.0175825
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    References listed on IDEAS

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    1. Timothy Kwok & Francis Mok & Wai Tong Chien & Eric Tam, 2006. "Does access to bed‐chair pressure sensors reduce physical restraint use in the rehabilitative care setting?," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(5), pages 581-587, May.
    2. Lisa A Simpson & William C Miller & Janice J Eng, 2011. "Effect of Stroke on Fall Rate, Location and Predictors: A Prospective Comparison of Older Adults with and without Stroke," PLOS ONE, Public Library of Science, vol. 6(4), pages 1-6, April.
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