뇌졸중 환자의 낙상 예방 프로그램 효과에 관한 체계적 문헌고찰 및 메타분석

Abstract

Purpose: This study aimed to systematically review and evaluate the effectiveness of fall prevention programs for stroke patients using a meta analysis. Methods: Systematic literature search was conducted for studies published between January 1, 2000, and October 31, 2024, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Of the 25 studies included in the systematic review, 20 were analyzed in the meta-analysis. The quality of randomized controlled trials was assessed using RoB 2.0, while non-randomized studies were evaluated using ROBINS-I. Comprehensive Meta-Analysis 4.0 software was used to calculate effect sizes (odds ratios, OR), hetero geneity (I² statistics), and publication bias. Subgroup analyses, funnel plots, Egger’s regression, and the Trim-and-Fill method were performed to assess bias. Results: The meta-analysis showed that fall prevention programs significantly reduced fall incidence among stroke patients, with an OR of 1.362 (95% CI: 1.13~1.64, p=.001). These programs also improved balance and gait. Subgroup analysis showed that rehabilitation and exercise programs had the strongest impact, while educational and assistive device-based programs showed moderate benefits. Conclusion: Fall prevention programs are effective in reducing falls and improving physical function in stroke patients. However, outcomes vary depending on program type and participant characteristics. In nursing practice, this highlights the importance of personalized, multidisciplinary strategies. Nurses play a key role in fall risk assessment, patient education, and intervention planning. Implementing evidence-based, structured fall pre vention interventions in nursing care can improve patient safety, promote functional recovery, and enhance quality of life after stroke.