Abstract：
OBJECTIVE: To evaluate the prevalence and factors associated with vestibular dysfunction in people who fall.
METHODS: All electronic records from MEDLINE, CINAHL, Embase and psycINFO databases were searched to 9 December 2022.
METHODS: Participants were adults with at least one fall within the previous year who were exposed to at least one vestibular function test. Any published peer reviewed trial designs were accepted. Included studies were assessed for risk of bias using a modified Epidemiological Appraisal Instrument. The quality of each meta-analysis was assessed using modified Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS: Ten trials (468 participants) were identified, six of which had high methodological quality. Vestibular dysfunction was found in 61% (48.01-72.32) I2 = 78% of participants. The most prevalent type of dysfunction was from tests of vestibulo-ocular reflex at 61% (49.79 to 70.49) I2 = 68%, followed by benign paroxysmal positional vertigo at 22% (10.30-40.32) I2 = 87% and central dysfunction at 11% (2.24-37.76) I2 = 50%. People who fall with vestibular dysfunction had reduced walking function compared to those without dysfunction -0.51 (-0.85 to -0.16) I2 = 11%. Dizziness was not related to vestibular dysfunction in people who fall 0.25 (-0.10 to 0.60), I2 = 0%. The quality of the body of evidence ranged from very low to high.
CONCLUSIONS: More than one in two people who fall have vestibular dysfunction. Clinicians cannot rely on dizziness report to indicate need for vestibular screening in those who fall. A vestibular screen should be incorporated into a comprehensive falls assessment.
METHODS: All electronic records from MEDLINE, CINAHL, Embase and psycINFO databases were searched to 9 December 2022.
METHODS: Participants were adults with at least one fall within the previous year who were exposed to at least one vestibular function test. Any published peer reviewed trial designs were accepted. Included studies were assessed for risk of bias using a modified Epidemiological Appraisal Instrument. The quality of each meta-analysis was assessed using modified Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS: Ten trials (468 participants) were identified, six of which had high methodological quality. Vestibular dysfunction was found in 61% (48.01-72.32) I2 = 78% of participants. The most prevalent type of dysfunction was from tests of vestibulo-ocular reflex at 61% (49.79 to 70.49) I2 = 68%, followed by benign paroxysmal positional vertigo at 22% (10.30-40.32) I2 = 87% and central dysfunction at 11% (2.24-37.76) I2 = 50%. People who fall with vestibular dysfunction had reduced walking function compared to those without dysfunction -0.51 (-0.85 to -0.16) I2 = 11%. Dizziness was not related to vestibular dysfunction in people who fall 0.25 (-0.10 to 0.60), I2 = 0%. The quality of the body of evidence ranged from very low to high.
CONCLUSIONS: More than one in two people who fall have vestibular dysfunction. Clinicians cannot rely on dizziness report to indicate need for vestibular screening in those who fall. A vestibular screen should be incorporated into a comprehensive falls assessment.
摘要：
目的：评估跌倒患者前庭功能障碍的患病率和相关因素。
方法：所有来自MEDLINE的电子记录，CINAHL,搜索Embase和psycINFO数据库至2022年12月9日。
方法：参与者是在前一年内至少有一次跌倒的成年人，他们接受了至少一项前庭功能测试。接受任何已发表的同行评审的试验设计。使用改良的流行病学评估工具评估纳入研究的偏倚风险。每个荟萃分析的质量都是使用改进的建议分级评估来评估的，开发和评估（等级）。
结果：确定了10项试验（468名参与者），其中六个具有较高的方法学质量。61％（48.01-72.32）的参与者发现前庭功能障碍I2=78％。最普遍的功能障碍类型来自前庭眼反射的测试，占61％（49.79至70.49）I2=68％，其次是22％（10.30-40.32）I2=87％的良性阵发性位置性眩晕和11％（2.24-37.76）I2=50％的中枢功能障碍。与没有前庭功能障碍的人相比，跌倒前庭功能障碍的人的步行功能降低-0.51（-0.85至-0.16）I2=11％。眩晕与跌倒0.25的人的前庭功能障碍无关（-0.10至0.60），I2=0%。证据的质量从很低到很高。
结论：1/2的跌倒者有前庭功能障碍。临床医生不能依靠头晕报告来表明跌倒者需要前庭筛查。前庭屏幕应纳入全面的跌倒评估。
方法：所有来自MEDLINE的电子记录，CINAHL,搜索Embase和psycINFO数据库至2022年12月9日。
方法：参与者是在前一年内至少有一次跌倒的成年人，他们接受了至少一项前庭功能测试。接受任何已发表的同行评审的试验设计。使用改良的流行病学评估工具评估纳入研究的偏倚风险。每个荟萃分析的质量都是使用改进的建议分级评估来评估的，开发和评估（等级）。
结果：确定了10项试验（468名参与者），其中六个具有较高的方法学质量。61％（48.01-72.32）的参与者发现前庭功能障碍I2=78％。最普遍的功能障碍类型来自前庭眼反射的测试，占61％（49.79至70.49）I2=68％，其次是22％（10.30-40.32）I2=87％的良性阵发性位置性眩晕和11％（2.24-37.76）I2=50％的中枢功能障碍。与没有前庭功能障碍的人相比，跌倒前庭功能障碍的人的步行功能降低-0.51（-0.85至-0.16）I2=11％。眩晕与跌倒0.25的人的前庭功能障碍无关（-0.10至0.60），I2=0%。证据的质量从很低到很高。
结论：1/2的跌倒者有前庭功能障碍。临床医生不能依靠头晕报告来表明跌倒者需要前庭筛查。前庭屏幕应纳入全面的跌倒评估。
