Home Environmental Factors That Could Impact Fear of Falling: A Systematic Review.

To catalog and study the effects of indoor home environmental factors associated with fear of falling (FOF) for 1) general population, 2) wheelchair (WC) users, and 3) persons with disability (PwD). PubMed, Web of Science, Scopus, and CINAHL until February 14th, 2023. KP and AA independently screened titles/abstracts. Articles were included if they met following criteria: original research, peer-reviewed, mentioned >= 1 indoor environmental factor, mentioned >=1 FOF outcome, English language. Fourteen of 4462 (2239 after duplicate removal) retrieved peer-reviewed articles meeting eligibility criteria were included in qualitative synthesis after discussions among KP, AA, and HM. Standardized data extraction tool developed by KP and HM was used by all the authors for information on author's name, publication year, purpose, study location, study characteristics (i.e., study design, sample size, age, target population), statistical method, list of indoor environmental factors, description and measurement of FOF. Author's KP and AA assessed Risk-of-bias (NIH tool). Overall quality of studies was moderate (2 studies = high quality, 0 = low). Preliminary results indicate at least seven studies reported positive association between various environmental modifications and FOF. One study reported no difference in FOF regarding housing type (apartment vs. house). Studies reported barriers of FOF like uneven, hard, slippery, shiny floors for PwD; cluttered environment, reach for objects, equipment failure for wheelchair users; and height of appliances, pathway obstacles, etc., across all populations surveyed. Whereas facilitators of FOF were grab bars, shower seats for PwD; grab bars, handles, and alarm in toilet, night light, white noise, etc., across all populations surveyed. Home hazards were not associated with FOF when measured using a single question, whereas associated with FOF based on Spinal Cord Injury-Fall Concerns Scale (SCI-FCS). Inappropriately installed potential facilitators (e.g., grab bars, wheelchair transfer setup) could serve as barriers that tend to increase FOF. Association of home environmental factors with FOF is sensitive to the measurement instrument of FOF. None. [ABSTRACT FROM AUTHOR]