Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis

Objective Even though 32%–83% for fear of falling (FoF) in patients with stroke, very little is known about the predictors of the problems. Therefore, we systematically reviewed the literature on risk factors for FoF in patients with stroke.Design A systematic review and meta-analysisData sources Pu...

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Main Authors: Li Ma, Qi Xie, Juhong Pei, Ling Gou, Yabin Zhang, Juanping Zhong, Yujie Su, Xinglei Wang, Xinman Dou
Format: Article
Language:English
Published: BMJ Publishing Group 2022-06-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/12/6/e056340.full
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author Li Ma
Qi Xie
Juhong Pei
Ling Gou
Yabin Zhang
Juanping Zhong
Yujie Su
Xinglei Wang
Xinman Dou
author_facet Li Ma
Qi Xie
Juhong Pei
Ling Gou
Yabin Zhang
Juanping Zhong
Yujie Su
Xinglei Wang
Xinman Dou
author_sort Li Ma
collection DOAJ
description Objective Even though 32%–83% for fear of falling (FoF) in patients with stroke, very little is known about the predictors of the problems. Therefore, we systematically reviewed the literature on risk factors for FoF in patients with stroke.Design A systematic review and meta-analysisData sources PubMed, Embase, Cochrane Library database, Web of Science, CINAHL, PsycINFO, Grey literature and other relevant databases for related publications were searched (from inception to 17 July 2021).Results Eight studies involving 1597 participants were selected to analyse risk factors for patients with stroke with FoF. The quality of all included studies was assessed and categorised as medium or high quality. Review Manager V.5.3 merged the OR value and 95% CI of the potential risk factors. Meta-regression and Egger’s test were performed by Stata V.15.1. The risk factors for FoF in patients with stroke were women (OR=2.13, 95% CI 1.47 to 3.09), impaired balance ability (OR=5.54; 95% CI 3.48 to 8.81), lower mobility (OR=1.12; 95% CI 1.05 to 1.19), history of falls (OR=2.33; 95% CI 1.54 to 3.53) and walking aid (OR=1.98; 95% CI 1.37 to 2.88), anxiety (OR=2.29; 95% CI 1.43 to 3.67), depression (OR=1.80; 95% CI 1.22 to 2.67), poor lower limb motor function (OR=1.14; 95% CI 1.00 to 1.29) and physically inactiveness (OR=2.04; 95% CI 1.01 to 4.12). Measurement of heterogeneity between studies was high for all outcomes (I2=0%–93%), indicating that the substantial interstudy heterogeneity in estimated proportions was not attributed to the sampling error. Sensitivity analysis (leave-one-out method) showed that the pooled estimate was stable.Conclusion This meta-analysis indicated that female population, impaired balance ability, lower mobility, history of falls and walking aid in patients with stroke might be at greater risk for FoF. Future studies are recommended to determine other risk factors specific to patients with stroke.
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spelling doaj-art-55f59b1f78ed41a7bb461525e2b12af12025-01-24T03:15:12ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-056340Risk factors for fear of falling in stroke patients: a systematic review and meta-analysisLi Ma0Qi Xie1Juhong Pei2Ling Gou3Yabin Zhang4Juanping Zhong5Yujie Su6Xinglei Wang7Xinman Dou8Department of Emergency, Peking University Third Hospital, Beijing, ChinaSchool of Nursing, Lanzhou University, Lanzhou, Gansu, ChinaThe First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, ChinaDepartment of Nursing, Qinghai Provincial People`s Hospital, Xining, Qinghai, ChinaNeurological Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, ChinaSchool of Nursing, Lanzhou University, Lanzhou, Gansu, ChinaSchool of Nursing, Lanzhou University, Lanzhou, Gansu, ChinaDepartment of Liver Diseases Branch, Lanzhou University Second Hospital, Lanzhou, Gansu, ChinaSchool of Nursing, Lanzhou University, Lanzhou, Gansu, ChinaObjective Even though 32%–83% for fear of falling (FoF) in patients with stroke, very little is known about the predictors of the problems. Therefore, we systematically reviewed the literature on risk factors for FoF in patients with stroke.Design A systematic review and meta-analysisData sources PubMed, Embase, Cochrane Library database, Web of Science, CINAHL, PsycINFO, Grey literature and other relevant databases for related publications were searched (from inception to 17 July 2021).Results Eight studies involving 1597 participants were selected to analyse risk factors for patients with stroke with FoF. The quality of all included studies was assessed and categorised as medium or high quality. Review Manager V.5.3 merged the OR value and 95% CI of the potential risk factors. Meta-regression and Egger’s test were performed by Stata V.15.1. The risk factors for FoF in patients with stroke were women (OR=2.13, 95% CI 1.47 to 3.09), impaired balance ability (OR=5.54; 95% CI 3.48 to 8.81), lower mobility (OR=1.12; 95% CI 1.05 to 1.19), history of falls (OR=2.33; 95% CI 1.54 to 3.53) and walking aid (OR=1.98; 95% CI 1.37 to 2.88), anxiety (OR=2.29; 95% CI 1.43 to 3.67), depression (OR=1.80; 95% CI 1.22 to 2.67), poor lower limb motor function (OR=1.14; 95% CI 1.00 to 1.29) and physically inactiveness (OR=2.04; 95% CI 1.01 to 4.12). Measurement of heterogeneity between studies was high for all outcomes (I2=0%–93%), indicating that the substantial interstudy heterogeneity in estimated proportions was not attributed to the sampling error. Sensitivity analysis (leave-one-out method) showed that the pooled estimate was stable.Conclusion This meta-analysis indicated that female population, impaired balance ability, lower mobility, history of falls and walking aid in patients with stroke might be at greater risk for FoF. Future studies are recommended to determine other risk factors specific to patients with stroke.https://bmjopen.bmj.com/content/12/6/e056340.full
spellingShingle Li Ma
Qi Xie
Juhong Pei
Ling Gou
Yabin Zhang
Juanping Zhong
Yujie Su
Xinglei Wang
Xinman Dou
Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis
BMJ Open
title Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis
title_full Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis
title_fullStr Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis
title_full_unstemmed Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis
title_short Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis
title_sort risk factors for fear of falling in stroke patients a systematic review and meta analysis
url https://bmjopen.bmj.com/content/12/6/e056340.full
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