School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China.
BMJ Open. 2022 Jun 30;12(6):e056340. doi: 10.1136/bmjopen-2021-056340.
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.
A systematic review and meta-analysis DATA 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).
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 (OR2.29; 95% CI 1.43 to 3.67), depression (OR=1.80; 95% CI 1.22 to 2.67), poor lower limb motor function (=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 ( =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.
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.
尽管有 32%-83%的脑卒中患者存在跌倒恐惧（Fear of Falling，FoF），但对于 FoF 的预测因素却知之甚少。因此，我们系统地回顾了脑卒中患者 FoF 的危险因素的相关文献。
系统综述和荟萃分析。
PubMed、Embase、Cochrane 图书馆数据库、Web of Science、CINAHL、PsycINFO、灰色文献和其他相关数据库，以检索相关出版物（从开始到 2021 年 7 月 17 日）。
共纳入 8 项研究，涉及 1597 名参与者，用于分析脑卒中患者 FoF 的危险因素。对所有纳入研究的质量进行评估，并归类为中等或高质量。Review Manager V.5.3 合并了潜在危险因素的 OR 值和 95%置信区间（CI）。Stata V.15.1 进行了荟萃回归和 Egger 检验。脑卒中患者 FoF 的危险因素为女性（OR=2.13，95%CI 1.47-3.09）、平衡能力受损（OR=5.54；95%CI 3.48-8.81）、活动能力下降（OR=1.12；95%CI 1.05-1.19）、有跌倒史（OR=2.33；95%CI 1.54-3.53）、使用助行器（OR=1.98；95%CI 1.37-2.88）、焦虑（OR=2.29；95%CI 1.43-3.67）、抑郁（OR=1.80；95%CI 1.22-2.67）、下肢运动功能较差（OR=1.14；95%CI 1.00-1.29）和身体不活跃（OR=2.04；95%CI 1.01-4.12）。所有结局的研究间异质性均较高（ =0%-93%），表明估计比例的实质性异质性不是由于抽样误差所致。敏感性分析（逐一剔除法）表明，汇总估计值是稳定的。
这项荟萃分析表明，女性、平衡能力受损、活动能力下降、有跌倒史和使用助行器可能是脑卒中患者 FoF 的更大风险因素。建议未来的研究确定特定于脑卒中患者的其他危险因素。
