16 Stroke Rehabilitation for Falls and Risk of Falls in Southeast Asia: A Scoping Review with Stakeholders’ Consultation

Abstract

Introduction: Stroke is a serious problem in Southeast Asia. Falls are common among stroke survivors especially within one-year post-stroke and the implication is devastating. Rehabilitation for stroke survivors is important especially to prevent falls. However, literature in Southeast Asia pertaining to the topic is sparse. This study aims to systematically identify literature related to stroke and falls in Southeast Asia. Method(s): This scoping review followed Levac, Colquhoun and O'Brien's framework. Systematic searching was conducted on four databases (MEDLINE, CINAHL, Scopus, ASEAN Citation Index) on August 2019. Generation of review question and keyword, and selection criteria were developed according to the Patient Intervention Comparison and Outcome (PICO) method. Consultation via several focus group discussions with stakeholders (i.e. stroke survivors, caregivers and therapists) were conducted and integrated with the synthesis of the review. Result(s): Initial search yielded 2412 articles after removing the duplicates; however, only 19 were accepted in the final analysis. Most of the articles focused on physical rehabilitation and using conventional therapies. While the literatures may reflect the practice in Southeast Asia, stakeholders perceived that the literature is inadequate to show the true practice, lack to inform and missed several aspects such as functional, cognitive and psychological intervention in managing falls. Home hazards are considered as contributing factors but not deemed important. Discussion(s): Individual-centric interventions dominated the review while communitybased and environmental-focused studies were limited. Only several articles were mainly written by physiotherapists while others are from medical physicians and engineers but negligible from other healthcare practitioners (i.e. occupational therapists, speech therapists, psychologists) or other disciplines interested with falls. Conclusion(s): Falls prevention among stroke survivors received lack of attention and just an indirect goal in stroke rehabilitation. More innovative research adopted from falls research with older people is needed to advance falls prevention and intervention practice with stroke survivors.