IMPAIRED GAIT AND BALANCE DISORDERS AS RISK MARKERS FOR FALLS IN CHRONIC CEREBRAL ISCHEMIA

Abstract

The main clinical syndromes of chronic cerebral ischemia (CCI) are impaired gait and balance disorders, which increase risks for falls. The objective of the study is to analyze correlation between impaired gait and postural instability to determine risk markers for falls in CCI patients. Materials and Methods. We examined 104 CCI patients (15 men and 89 women, median age 70 (63; 76) years). The patients did not have significant functional limitations in daily life (modified Rankin scale, 0–2 points). Thirteen patients (13 %) had a history of acute cerebrovascular accidents, thirty-seven patients (36 %) had a history of falls. Moderate cognitive impairment was detected in 53 patients (51 %). Impaired gait and balance disorders were assessed according to Tinetti test, Berg balance scale, and stabilometric platform. Statistica 13.0, SPSS 22 was used for statistical data processing. Results. According to the Tinetti test, impaired gait was detected in 101 patients (97 %), balance disorders were found in 32 patients (31 %). According to the Berg balance scale, most patients had a low risk for falls. Stabilometry showed a decrease in the limits of stability, mainly forward. Discriminant analysis revealed that significant predictors of falls in CCI patients are the “forward” limit of stability (<59 points), female gender, age (>67 y.o.), depression (>9 points, HADS), sway index (eyes closed) in the clinical test for sensory integration and balance (>0.855), balance score for the Tinetti test (<15 points), and a history of acute cerebrovascular accident. Conclusion. Stabilometry along with clinical assessment can improve the effectiveness of determining the risk group for falls in CCI patients.