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

Background The incidence rate of fear of falling in chronic stroke is high, which seriously affects the quality of life and rehabilitation effect of patients. Early identification of its risk factors will help clinical screening of high-risk patients and prevent their further development. There is currently no systematic evaluation of risk factors for fear of falling falls in chronic stroke. Objective We systematically reviewed the literature on risk factors for fear of fall in chronic patients with stroke. Method We systematically searched PubMed, Embase,cochrane,Web of Science and the China National Knowledge Infrastructure(CNKI),the china biomedical literature database(CBM),the China Science and Technology Periodicals Database(VIP),Wangfang data for relevant literature until May 2023.Review Manager V.5.3 merged the OR value and 95% CI of the potential risk factors.A random/fixed-effect meta-analysis was used to pool risk factors from individual studies.Cochran’s Q and the I 2 tests were used to assess heterogeneity between the studies. Results A total of 6 studies were included for the final analysis, with 965 chronic stroke patients. The risk factors for fear of falling in chronic patients with stroke were impaired balance ability (OR=3.05; 95% CI 1.60 to 5.80), history of falls (OR=2.12; 95% CI 1.40 to 3.20) and 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),physically inactiveness (OR=2.04; 95% CI 1.01 to 4.12). Married (OR=0.61; 95% CI: 0.435-0.875) is a protective factor. Conclusion Our study shows that impaired balance ability, history of falls might be a greater risk for fear of falling. Future studies are recommended to determine other risk factors specific to patients with chronic stroke.