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[Falls in patients with stroke].

Falls are the most common medical complication during the post-stroke period. Falls are of great concern in this population in particular because of their severe consequences. Stroke survivors have an increased frequency of hip fracture and psychosocial problems such as fear of falling. The most important risk factors for falls in these patients are balance and gait deficits. Balance deficits in post-stroke patients entail reduced postural stability during standing and disturbed responses to self-induced and external balance perturbations. Gait deficits in post-stroke patients involve reduced propulsion at push-off, disturbed hip and knee flexion in the swing phase and disturbed stability in the stance phase. Beneficial effects can be expected from fall prevention programs targeting these deficits. The few studies that have evaluated the efficacy of task-oriented exercises have shown that these programs are the most promising in preventing falls in post-stroke patients. Technological advances in assistive devices also have potential for fall reduction. Larger randomized controlled trials are needed to provide more conclusive evidence.