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Tian X, Mai YH, Guo ZJ, Chen JW, Zhou LJ. Contributing factors and interventions for fear of falling in stroke survivors: a systematic review. Top Stroke Rehabil 2024:1-16. [PMID: 38566465 DOI: 10.1080/10749357.2024.2333172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES The purpose of this study was to provide a comprehensive overview of the prevalence, measurement tools, influencing factors, and interventions for fear of falling (FOF) in stroke survivors. METHODS A PRISMA-guided systematic literature review was conducted. PubMed, EMBASE, Cochrane, and Web of Science were systematically searched. The search time was up to February 2023. All observational and experimental studies investigating FOF in stroke patients were included. The assessment tool of the Joanna Briggs Institute was used to assess the quality of the included studies and the risk of bias assessment. (PROSPERO: CRD42023412522). RESULT A total of 25 observational studies and 10 experimental studies were included. The overall quality of the included studies was "low" to "good." The most common tool used to measure the FOF was the Falls Efficacy Scale-International (FES-I). The prevalence of FOF was 42%- 93.8%. Stroke survivors with physical impairments have the highest prevalence of FOF. The main risk factors for the development of FOF in stroke survivors were female gender, use of assistive devices, balance, limb dysfunction, and functional mobility. The combination of cognitive behavioral and exercise interventions is the most effective strategy. CONCLUSIONS This review suggests that the prevalence of FOF in stroke survivors is high and that understanding the factors associated with FOF in stroke patients can help develop multifactorial prevention strategies to reduce FOF and improve quality of life. In addition, a uniform FOF measurement tool should be used to better assess the effectiveness of interventions for stroke survivors. ETHICS APPROVAL PROSPERO registration (CRD42023412522).
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Affiliation(s)
- Xue Tian
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Ying-Hong Mai
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Zai-Jin Guo
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Jia-Wen Chen
- School of Nursing, School of Public Health, Yangzhou University, Yangzhou, China
| | - Luo-Jing Zhou
- Science and Technology Division, North Jiangsu People's Hospital of Jiangsu province, Yangzhou, China
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Kerdsawatmongkon J, Nualnetr N, Isariyapan O, Kitreerawutiwong N, Srisoparb W. Effects of Home-Based Boxing Training on Trunk Performance, Balance, and Enjoyment of Patients With Chronic Stroke. Ann Rehabil Med 2023; 47:36-44. [PMID: 36635885 PMCID: PMC10020051 DOI: 10.5535/arm.22127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 12/12/2022] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE To investigate the effect of 6 weeks of home-based boxing training on trunk performance, balance, fear of falling, and level of therapy enjoyment in individuals with chronic stroke. METHODS Eighteen participants with chronic stroke were randomly divided into boxing and control groups (9 patients per group). The boxing group received home-based boxing training for 25 minutes plus balance and trunk exercise training for 15 minutes, while the control group received only home-based balance and trunk exercise training for 40 minutes, three days a week for 6 weeks. The Trunk Impairment Scale (TIS), Mini-Balance Evaluation Systems Test (Mini-BESTest), Activities-specific Balance Confidence (ABC) scale, and Physical Activity Enjoyment Scale (PACES) were assessed at baseline, and at 2, 4, and 6 weeks post-training. The Wilcoxon signed rank test and Mann-Whitney U-test were used to determine differences between pre- and post-training within and between groups. Statistical significance was set at p<0.05. RESULTS The TIS scores significantly increased from 13 to 17 points in the boxing group (p<0.05) compared to an increase from 15 to 17 points in the control group (p<0.05). The Mini-BESTest scores significantly increased from 14 to 22 points in the boxing group (p<0.05) compared to an increase from 17 to 20 points in the control group (p<0.05). There were no differences in the TIS, Mini-BESTest, ABC, and PACES scores between the two groups. CONCLUSION Home-based boxing training with balance and trunk exercise training had a similar training effect compared to home-based balance and trunk exercise training.
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Affiliation(s)
- Jeerawan Kerdsawatmongkon
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.,Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Nomjit Nualnetr
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Northeastern Stroke Research Group, Khon Kaen University, Khon Kaen, Thailand.,Research and Training Center for Enhancing Quality of Life of Working-Age People, Khon Kaen University, Khon Kaen, Thailand
| | - Olan Isariyapan
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.,Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | | | - Waroonnapa Srisoparb
- Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand.,Exercise and Rehabilitation Sciences Research Unit, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
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Xie Q, Pei J, Gou L, Zhang Y, Zhong J, Su Y, Wang X, Ma L, Dou X. Risk factors for fear of falling in stroke patients: a systematic review and meta-analysis. BMJ Open 2022; 12:e056340. [PMID: 35772831 PMCID: PMC9247667 DOI: 10.1136/bmjopen-2021-056340] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
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-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). 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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Affiliation(s)
- Qi Xie
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Juhong Pei
- The First Clinical Medical College, Lanzhou University, Lanzhou, Gansu, China
| | - Ling Gou
- Department of Nursing, Qinghai Provincial People's Hospital, Xining, Qinghai, China
| | - Yabin Zhang
- Neurological Intensive Care Unit, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Juanping Zhong
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Medical Department of Neurology, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Yujie Su
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xinglei Wang
- Department of Liver Diseases Branch, Lanzhou University Second Hospital, Lanzhou, Gansu, China
| | - Li Ma
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xinman Dou
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
- Department of Nursing, Lanzhou University Second Hospital, Lanzhou, Gansu, China
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Improving Spatiotemporal Gait Asymmetry Has Limited Functional Benefit for Individuals Poststroke. J Neurol Phys Ther 2020; 44:197-204. [DOI: 10.1097/npt.0000000000000321] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Peeters G, Bennett M, Donoghue OA, Kennelly S, Kenny RA. Understanding the aetiology of fear of falling from the perspective of a fear-avoidance model – A narrative review. Clin Psychol Rev 2020; 79:101862. [DOI: 10.1016/j.cpr.2020.101862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 05/06/2020] [Accepted: 05/09/2020] [Indexed: 12/14/2022]
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Yadav T, Bhalerao G, Shyam AK. Factors affecting fear of falls in patients with chronic stroke. Top Stroke Rehabil 2019; 27:33-37. [PMID: 31847729 DOI: 10.1080/10749357.2019.1658419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of this study was to find the factors associated with fear of falls in patients having chronic stroke.Methods: Inclusion criterion was subjects with cerebral stroke for more than 3 months. A structured interview of 82 subjects was conducted with a questionnaire with questions regarding personal factors such as gender, side affected, number of comorbidities, and setting of physical therapy sessions. Depression was assessed using Patient Health Questionnaire-9, lower extremity motor function was assessed using Fugl-Meyer scale, and functional mobility was assessed using Timed Up and Go. Chi-square analysis was done on the above factors to find significant factors followed by logistic regression of the factors found significant in Chi square.Results: Lower extremity Fugl-Meyer score was significantly associated with fear of falls (p value 0.047 with Odds ratio of 1.136, 95% CI 1.002-1.287) in patients having chronic stroke while treatment factors, such as setting of physical therapy sessions, and personal factors, such as gender, side affected, number of comorbidities, depression, functional mobility, or use of walking aid, were not found to have significant association.Conclusion: The lower extremity Fugl-Meyer score is associated with fear of falls in patients having chronic stroke.
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Affiliation(s)
- Trishala Yadav
- Neuro Physiotherapy Department, Sancheti Institute College of Physiotherapy, Pune, India
| | - Gajanan Bhalerao
- Neuro Physiotherapy Department, Sancheti Institute College of Physiotherapy, Pune, India
| | - Ashok K Shyam
- Neuro Physiotherapy Department, Sancheti Institute for Orthopaedics and Rehabilitation, Pune, India
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Grey matter activation by caloric stimulation in patients with unilateral peripheral vestibular hypofunction. Neuroradiology 2019; 61:585-593. [DOI: 10.1007/s00234-019-02194-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Accepted: 02/25/2019] [Indexed: 11/28/2022]
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Larén A, Odqvist A, Hansson PO, Persson CU. Fear of falling in acute stroke: The Fall Study of Gothenburg (FallsGOT). Top Stroke Rehabil 2018; 25:256-260. [DOI: 10.1080/10749357.2018.1443876] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Amanda Larén
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Amanda Odqvist
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Per-Olof Hansson
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Carina U. Persson
- Department of Clinical Neuroscience, Rehabilitation Medicine, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
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