Citation

Xu T, Clemson L, O'Loughlin K, Lannin NA, Dean C, Koh G. Arch. Phys. Med. Rehabil. 2018; 99(3): 563-573.e5.

Affiliation

Saw Swee Hock School of Public Health, National University of Singapore, Singapore.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.apmr.2017.06.032

PMID

28797618

Abstract

OBJECTIVE: To identify the risk factors for falls in community stroke survivors. DATA SOURCES: A comprehensive search for articles indexed on MEDLINE, EMBASE, CINAHL, PsychINFO, Cochrane Library, and Web of Science databases was conducted. STUDY SELECTION: Prospective studies investigating fall risk factors in community stroke survivors were included. Reviewers in pair independently screened the articles and determined inclusion through consensus. Studies meeting acceptable quality rating using the Q-Coh were included in the meta-analysis. DATA EXTRACTION: Data extraction was done in duplicate by four reviewers using a standardized data extraction sheet, and confirmed by another independent reviewer for completeness and accuracy. DATA SYNTHESIS: Twenty-one articles met the minimum criteria for inclusion; risk factors investigated by three or more studies (n=16) were included in a meta-analysis. The following risk factors had strong association with all fallers: impaired mobility (OR 4.36, CI 2.68-7.10); reduced balance (OR 3.87, CI 2.39-6.26); use of sedative / psychotropic medications (OR 3.19, CI 1.36-7.48); disability in self-care (OR 2.30, CI 1.51-3.49); depression (OR 2.11, CI 1.18-3.75); cognitive impairment (OR 1.75, CI 1.02-2.99); and history of fall (OR 1.67, CI 1.03-2.72). A history of falling (OR 4.19, CI 2.05-7.01) had a stronger association with recurrent fallers.

CONCLUSIONS: This study confirms that balance and mobility problems, assisted self-care, taking sedative or psychotropic medications, cognitive impairment, depression, and history of falling are associated with falls in community stroke survivors. We recommend that any future research into falls prevention programs should consider addressing these modifiable risk factors. As the risk factors for falls in community stroke survivors are multifactorial, interventions should be multi-dimensional.

Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Accidental falls; Community; Rehabilitation; Risk factors; Stroke