Post stroke communication disability: a risk factor for falls in inpatient rehabilitation

Mrs Rebecca Sullivan1

1Eastern Health, Burwood, Australia


To investigate whether there is an association between severe communication disability and falls among patients receiving inpatient rehabilitation after stroke.

Patients consecutively admitted to Eastern Health rehabilitation wards following a stroke were studied retrospectively. Demographic data, premorbid falls risk factors, communication profile, presence of functional communication to meet basic needs (determined by the patient’s ability to meet their basic needs using any communication method) and new cognitive impairment were studied. Incidence of falls per day and risk ratio was calculated.

149 patients were included in the study.  The 32 patients in the sample (34%) who did not have functional communication (i.e. were unable to communicate their basic needs) were almost twice as likely to fall in hospital as those with functional communication (RR 1.94, 95% CI 1.15 to 3.24). Several commonly assessed factors were not significant predictors of falls in this population.

Significance of the findings to allied health:
Falls in hospital are a common and serious complication of stroke.  The presence of a communication disability in stroke survivors is not routinely considered when assessing a patients risk for a fall.  The findings of this study suggest that existing factors used to predict falls risk may not be effective in this population and that communication disability may be under recognised as a falls risk factor after stroke.


Rebecca is a Senior Speech Pathologist within Eastern Health.  Rebecca has over 12 years experience working with adults in subacute care in both hospital and community settings.  Rebecca is passionate about working to empower patients to be an active participant in their healthcare decisions.  Rebecca has previously published research in the area of Allied Health Assistant training using a traineeship model.