Association between modified Rankin Scale scores and fall risk in post-stroke rehabilitation inpatients: a cross-sectional study

Falls are among the most common complications after stroke, potentially delaying functional recovery. Although the modified Rankin Scale (mRS) is widely used in stroke assessment, its relationship with fall risk remains poorly understood. The study aims to identify the association between mRS scores and fall risk in stroke patients. In this multicenter cross-sectional study, data on sociodemographics, clinical factors, fall characteristics, and mRS scores were collected via face-to-face interviews. Univariate analysis, binary logistic regression, and threshold effect models were employed to examine the association between fall risk and mRS scores. Among 6,192 enrolled patients, 524 (8.46%) experienced falls. The mRS showed a non-linear association with fall risk, peaking at mRS = 3 (P < 0.05). For scores < 3, each 1-point increase in mRS raised fall risk by 34% (OR = 1.32, 95% CI: 1.09- 1.60, P = 0.0046), whereas for scores > 3, each 1-point increase reduced risk by 26% (OR = 0.74, 95% CI: 0.61-0.90, P = 0.0027). An inverted U-shaped relationship exists between mRS scores and fall risk, peaking at an mRS score of 3, identifying a potential priority group for fall prevention.