Determinants of Falls and Fear of Falling in Ambulatory Persons With Late Effects of Polio

Abstract

IV.

Is intervention to prevent falls necessary in prior polio patients?

“…Seventy-five percent of the patients reported that they had fallen at least once in the past year, which is similar to the results of previous studies on falls in patients with prior polio (5,9). Other studies (6,8,(10)(11)(12)(13) have reported a fall rate of 59-69% in the same patient group. Regarding falls during the past year, people with prior polio have more than twice as many falls as the general population, 65 years of age and older (14).…”

“…A large proportion of the patients experienced fear of falling, as in previous studies (5,8,9) and approximately half of the patients had decreased their walking due to fear of falling. A contributing cause of increased frequency of falls and fear of falling in patients with prior polio may be the increase in slow muscle fibres and a loss of fast muscle fibres (18)(19)(20), which can lead to poorer ability to quickly avoid obstacles when walking.…”

“…Many patients with prior polio have muscle weakness in the lower extremities (1), which limits their movements and has been shown to be directly related to falls (4)(5)(6). Patients with prior polio often have a decreased balance and walking speed compared with healthy controls of the same age (7), they are known to have a fear of falling (5,6,(8)(9) and have been reported to fall often (5,6,(8)(9)(10)(11)(12)(13). It is important to identify the circumstances and consequences of falls in patients with prior polio, in order to prevent falls and fear of falling, and to analyse the necessity of interventions to prevent falling.…”

Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio: A qualitative study

“…Similar consequences of fear of falling are described in persons with MS (19), stroke (17) and SCI (18). Previous studies of persons with LEoP have used different versions of the Falls Efficacy Scale (1,5,8,25) to assess fear of falling, and have reported that fear seems to be greatest in activities related to walking. It was also evident here that fear of falling was common during ambulation.…”

“…It has been shown that reduced muscle strength in the lower limbs (5,8,9), decreased postural control (5,8,15), leg-length discrepancies (9) and walking limitations (1,8) are associated with falls in persons with LEoP. However, this qualitative study has provided a deeper understanding of how impairments following LEoP can affect movement control and walking ability, which makes people more vulnerable to barriers in different surroundings and to seasonal changes.…”