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    What works in falls prevention after stroke?: A systematic review and meta-analysis

    Access Status
    Open access via publisher
    Authors
    Batchelor, F.
    Hill, Keith
    MacKintosh, S.
    Said, C.
    Date
    2010
    Type
    Journal Article
    
    Metadata
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    Citation
    Batchelor, F. and Hill, K. and MacKintosh, S. and Said, C. 2010. What works in falls prevention after stroke?: A systematic review and meta-analysis. Stroke. 41 (8): pp. 1715-1722.
    Source Title
    Stroke
    DOI
    10.1161/STROKEAHA.109.570390
    ISSN
    0039-2499
    School
    School of Physiotherapy and Exercise Science
    URI
    http://hdl.handle.net/20.500.11937/39548
    Collection
    • Curtin Research Publications
    Abstract

    Background and Purpose-: Falls are common after stroke. Despite evidence that single and multifactorial interventions can reduce falls in older people, this issue remains relatively underexplored in stroke survivors. Effective fall prevention in this population has the potential to prevent injury, improve quality of life, and decrease the likelihood of subsequent fear of falling and activity restriction. The aim of this article was to review and integrate the research evidence relating to interventions that reduce falls after stroke. Methods-: Published studies evaluating interventions to reduce falls in stroke survivors were retrieved and screened according to predetermined criteria. Included studies were independently assessed. Quality of trials was assessed using the Physiotherapy Evidence Database score. Pooling of results was undertaken for similar interventions with comparable outcomes using the inverse variance method. Results-: Thirteen studies met the inclusion criteria, with pooling of results possible for only 2 types of intervention. Methodological quality of the included studies was variable with the main bias because of lack of blinding of participants and those administering the intervention. Variability in falls data reporting was seen across the studies. The only intervention shown to be effective in reducing falls was vitamin D for female stroke survivors in an institutional setting. Other interventions were no more effective than usual care. Conclusions-: Fall risk is high in stroke survivors; however, the only intervention shown to be effective in reducing falls in this review was vitamin D supplementation. Consistency in outcome measurement would enable comparisons across studies. Additionally, further research evaluating a range of single and multifactorial interventions for fall prevention in the stroke population is required. © 2010 American Heart Association, Inc.

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