Article

Health professionals view falls after stroke as common adverse events
with both physical and psychological consequences. Stroke survivors' experiences
are less well understood.
The aim of this systematic review was to explore the
perception of falls-risk within the stroke recovery experience from the
perspective of people with stroke. METHODS: A systematic literature search was
conducted. Papers that used qualitative methods to explore the experiences of
individuals with stroke around falls, falls-risk and fear of falling were
included. Two reviewers independently assessed the methodological quality of
papers. Meta-ethnography was conducted. Concepts from each study were translated
into each other to form theories that were combined through a "lines-of-argument"
synthesis. RESULTS: Four themes emerged from the six included qualitative
studies: (i) Fall circumstances, (ii) perception of fall consequences, (iii)
barriers to community participation and (iv) coping strategies. The synthesis
revealed that stroke survivors' perceived consequences of falls exist on a
continuum. Cognitive and emotional adjustment may be required in the successful
adoption of coping strategies to overcome fall-related barriers to participation.
CONCLUSIONS: Stroke survivors' fall-related experiences appear to exist within
the context of activity and community participation. Further research is
warranted due to the small number of substantive studies available for synthesis.
Implications for Rehabilitation Health care professionals should recognize that
cognitive and emotional adjustment may berequired for stroke survivors to accept
strategies for overcoming falls-risk, including dependenceon carers and assistive
devices. Several factors in addition to physical interventions may be needed to
minimize falls-risk whileincreasing activity participation.
These factors could
include increasing public awareness about the effects of stroke and
falls-risk,and ensuring access to psychological services for stroke survivors.
Rehabilitation professionals should reflect on whether they perceive there to be
an appropriatelevel of fear of falling post-stroke. They should understand that
stroke survivors might not conceptualize falls-risk in this way.

Langue : ANGLAIS