Fear of falling in stroke patients: relationship with previous falls and functional characteristics

Abstract

The objectives of this study were to determine the relationship between fear of falling and functional characteristics of patients after stroke as well as to determine what characterizes fallers who score high fall-related self-efficacy, and nonfallers who score low fall-related self-efficacy. Patients (n=140) treated in a stroke unit during a 12-month period were included. On follow-up, fallers were identified and patients answered the questions in the Falls Efficacy Scale, Swedish version (FES-S). Assessments of motor capacity, functional mobility and balance were also made. In univariate analysis, low fall-related self-efficacy was significantly associated with increased age, female sex, earlier falls, visual and cognitive impairment, low mood and impaired physical function. In multivariate analysis, only earlier falls and physical function remained significant. Twenty percent of the patients scored low fall-related self-efficacy without having experienced a fall, and 11% who experienced a fall scored high fall-related self-efficacy. Impaired physical function was significantly associated with scoring low fall-related self-efficacy, for both fallers and nonfallers. Fear of falling is significantly associated with poor physical function and earlier falls. Falls Efficacy Scale, Swedish version could add useful information to a fall risk analysis. Patients scoring low fall-related self-efficacy should be offered fall prevention measures whether they have fallen or not.

Guidelines for Adult Stroke Rehabilitation and Recovery

“…Studies indicate that 30% to 80% of individuals with stroke report various levels of fear associated with falling and mobility. 178 Fear of falling can lead to reduced levels of physical activity and deconditioning, creating a cascade that may result in greater declines in physical activity, a decrease in ADLs, a loss of independence, fewer community interactions, social isolation, and depression. Ironically, the reduction in physical activity resulting from fear of falling can itself contribute to an increased risk of falls.…”

Fear of Falling Among People Who Have Sustained a Stroke: A 6-Month Longitudinal Pilot Study

“…Therapists consider poststroke FoF to be a primary barrier to functional recovery (Schmid, Butterbaugh, Egolf, Richards, & Williams, 2008). In addition, researchers have found poststroke FoF to be associated with lower community reintegration satisfaction, decreased physical functioning, and minimized perceived health status (Andersson, Kamwendo, & Appelros, 2008;Pang, Eng, & Miller, 2007;Salbach et al, 2006). The prevalence, severity, and impact of FoF on anxiety, depression, QoL, and balance over time after a stroke, however, remain unknown.…”

Discriminant analysis for predictor of falls in stroke patients by using the Berg Balance Scale

“…Falls in stroke patients with chronic disabilities have been associated with poor balance and mobility. (10,19) Several studies have shown that balance, (9,11) activities of daily living (8,19) and cognitive deficits are risk factors for falls in stroke patients. (9,19) Several predictors of falls have also been identified in individuals in the acute and subacute phases of stroke recovery.…”

“…(6)(7)(8)(9) Hyndman et al reported that disturbances in balance increase the risk of falls. (10) Teasell et al reported that significant differences were observed between non-fallers and fallers in terms of the presence of apraxia and defective cognitive function; they also reported that stroke patients with reduced cognitive function had difficulty following instructions to ensure safety in walking and transfer.…”