Abdollahi Masoud, Whitton Natalie, Zand Ramin, Dombovy Mary, Parnianpour Mohamad, Khalaf Kinda, Rashedi Ehsan
Industrial and Systems Engineering Department, Rochester Institute of Technology, Rochester, NY, United States.
Department of Neurology, Geisinger Neuroscience Institute, Danville, PA, United States.
Front Bioeng Biotechnol. 2022 Aug 8;10:910698. doi: 10.3389/fbioe.2022.910698. eCollection 2022.
To prevent falling, a common incident with debilitating health consequences among stroke survivors, it is important to identify significant fall risk factors (FRFs) towards developing and implementing predictive and preventive strategies and guidelines. This review provides a systematic approach for identifying the relevant FRFs and shedding light on future directions of research. A systematic search was conducted in 5 popular research databases. Studies investigating the FRFs in the stroke community were evaluated to identify the commonality and trend of FRFs in the relevant literature. twenty-seven relevant articles were reviewed and analyzed spanning the years 1995-2020. The results confirmed that the most common FRFs were age (21/27, i.e., considered in 21 out of 27 studies), gender (21/27), motion-related measures (19/27), motor function/impairment (17/27), balance-related measures (16/27), and cognitive impairment (11/27). Among these factors, motion-related measures had the highest rate of significance (i.e., 84% or 16/19). Due to the high commonality of balance/motion-related measures, we further analyzed these factors. We identified a trend reflecting that subjective tools are increasingly being replaced by simple objective measures (e.g., 10-m walk), and most recently by quantitative measures based on detailed motion analysis. There remains a gap for a standardized systematic approach for selecting relevant FRFs in stroke fall risk literature. This study provides an evidence-based methodology to identify the relevant risk factors, as well as their commonalities and trends. Three significant areas for future research on post stroke fall risk assessment have been identified: 1) further exploration the efficacy of quantitative detailed motion analysis; 2) implementation of inertial measurement units as a cost-effective and accessible tool in clinics and beyond; and 3) investigation of the capability of cognitive-motor dual-task paradigms and their association with FRFs.
为预防跌倒（这是中风幸存者中常见且会导致健康状况恶化的事件），识别重大跌倒风险因素（FRF）对于制定和实施预测性及预防性策略与指南至关重要。本综述提供了一种系统方法来识别相关的跌倒风险因素，并阐明未来的研究方向。我们在5个常用研究数据库中进行了系统检索。对调查中风群体中跌倒风险因素的研究进行评估，以确定相关文献中跌倒风险因素的共性和趋势。对1995年至2020年间的27篇相关文章进行了综述和分析。结果证实，最常见的跌倒风险因素是年龄（27项研究中有21项考虑了该因素）、性别（27项研究中有21项）、与运动相关的指标（27项研究中有19项）、运动功能/损伤（27项研究中有17项）、与平衡相关的指标（27项研究中有16项）以及认知障碍（27项研究中有11项）。在这些因素中，与运动相关的指标具有最高的显著性比例（即84%或16/19）。由于与平衡/运动相关的指标具有高度共性，我们进一步分析了这些因素。我们发现一种趋势，即主观工具正越来越多地被简单的客观测量方法（如10米步行测试）所取代，最近又被基于详细运动分析的定量测量方法所取代。在中风跌倒风险文献中，选择相关跌倒风险因素的标准化系统方法仍存在差距。本研究提供了一种基于证据的方法来识别相关风险因素及其共性和趋势。已确定中风后跌倒风险评估未来研究的三个重要领域：1）进一步探索定量详细运动分析的有效性；2）将惯性测量单元作为一种经济高效且易于获取的工具应用于临床及其他领域；3）研究认知 - 运动双任务范式的能力及其与跌倒风险因素的关联。
