How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations

Young, William R.; Williams, A. Mark

doi:10.1016/j.gaitpost.2014.09.006

Cited by 277 publications

(273 citation statements)

References 28 publications

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“…The FoF consists of an anxiogenic response that can favor the actual event of falls [45,46]. The increase in the CoP mean velocity (as observed in the present study, Figure 2B) has been considered an important predictor of the risk of falls in the elderly [26,43].…”

Section: Discussionsupporting

confidence: 64%

Effect of Cervical Kinesthetic Motor Imagery on Postural Control of Healthy Young Adults with Fear of Falling

Souza

Martins

Ferreira

et al. 2017

JFMK

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Motor imagery (MI) is the act of coding the mental aspect of an intended task without executing it. Fear consists of an anxiogenic response to a previous event, which provides a state of alertness to the individual in the face of a threat. These two conditions (imagery and fear) may modulate orthostatic postural control, but their combined effect is still unknown. To investigate whether cervical kinesthetic motor imagery induces modulations in postural control and in the fear of falling (FoF) sensation in healthy young adults. Participants (n = 20) were placed on the Wii Balance Board ® and oriented to perform and imagine three tasks for 60 s: (1) closed eyes; (2) cervical flexion; and (3) cervical inclination. The number of performed and imagined repetitions were recorded, and participants responded to a question at the end of each task regarding the FoF. There were four relevant effects: (1) there was no difference between the number of performed and imagined repetitions (p > 0.05) indicating similarities; (2) there was a greater sensation of FoF induced by kinesthetic MI tasks (p < 0.001); (3) there was a greater modulation of the center of pressure (mean velocity and amplitude) in the anteroposterior direction in phobic subjects (p < 0.05); and (4) there was no modulation between the non-phobic subjects in the anteroposterior direction (p > 0.05). The FoF during kinesthetic MI tasks may influence the orthostatic postural control, favoring the reduction in postural stability.

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Section: Discussionsupporting

confidence: 64%

Effect of Cervical Kinesthetic Motor Imagery on Postural Control of Healthy Young Adults with Fear of Falling

Souza

Martins

Ferreira

et al. 2017

JFMK

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“…Future research could also assess whether the well-established anxiety-related reduction in sway under stress is adaptive or maladaptive in terms of whether it increases or decreases susceptibility to a fall in young but also in older adults. In general, stiffening is considered a conservative strategy used to prepare the body for a potential disturbance (Young and Williams 2015). It is thought that such adaptations are likely to be beneficial during relatively static balance tasks, but maladaptive in situations, where dynamic responses or preplanned movements are required.…”

Section: Discussionmentioning

confidence: 99%

Cognitively and socially induced stress affects postural control

2017

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Postural control is an adaptive process that can be affected by many aspects of human behavior, including emotional contexts. The main emotional contexts that affect postural control are postural threat and passive viewing of aversive or threatening images, both of which produce a reduction in postural sway. The aim of the present study was to assess whether similar stress-related changes in postural sway can be observed using stress induced by social evaluative threat (SET) while performing arithmetic tasks. Twelve young adults performed an arithmetic and a postural control task separately, concurrently, and concurrently with added time pressure in the arithmetic task. In the final condition, participants were given negative feedback about their performance in the arithmetic task and performed it again while being observed (SET condition). Results showed that stress increased linearly with task demand. Postural sway and reaction times were not affected by the first two conditions; however, when time pressure was introduced, reaction times became faster and sway amplitude increased. Finally, introduction of SET caused the predicted reduction in postural sway and an increase in reaction times relative to the time pressure condition. Our results suggest that stress induced using a combination of arithmetic tasks and social evaluative threat leads to systematic changes in postural control. The paradigm developed in the present study would be very useful in assessing interactions between cognition, stress, and postural control in the context of postural instability and falls in older adults.

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“…O medo de cair pode ser identificado como um fator de risco para redução na qualidade de vida, restrição das atividades, redução da independência e risco de quedas na população idosa [15]. Segundo Amador et al [16], o medo de cair pode estar associado ao avanço da idade, déficits de equilíbrio e diminuição da força muscular, levando à restrição da atividade física e interferindo na independência do idoso.…”

Section: Discussionunclassified

Institucionalização e atividade física em idosos e suas relações com medo de cair e qualidade de vida

Rachadel¹,

Broering²,

Luza³

et al. 2015

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. RESUMOObjetivos: Avaliar a associação da institucionalização e da prática de atividade física com o medo de cair e a qualidade de vida de idosos. Métodos: Foram selecionados para este estudo 61 idosos, divididos em três grupos: 21 institucionalizados, 20 não institucionalizados ativos e 20 não institucionalizados não ativos. Foram utilizados como instrumentos o questionário FES-I para avaliar o medo de cair e o questionário SF-36 para avaliação da qualidade de vida. Os participantes foram recrutados em instituições de longa permanência e entre idosos da comunidade, residentes na Grande Florianópolis. Os dados foram analisados por meio de estatística descritiva e inferencial (Anova One Way, testes de Kruskall-Wallis e U de Mann-Whitney) com nível de significância de p≤0,05. Resultados: No questionário FES-I houve diferença significativa entre os idosos institucionalizados e não institucionalizados ativos, com maior pontuação nos institucionalizados (30±10,5; p=0,02), significando maior preocupação com quedas. Na avaliação da qualidade de vida foi observada diferença significativa entre os grupos no domínio capacidade funcional, com maior pontuação nos não institucionalizados ativos (78±19,6), seguidos pelos não institucionalizados não ativos (51±27,3) e institucionalizados (35,9±25,9) (p=0,001). No domínio dor, a maior pontuação (menos dor) foi nos institucionalizados (83,2±21,6), seguidos pelos não institucionalizados ativos (61,4±25,9) e não institucionalizados não ativos (54,4±33,3) (p=0,005). Conclusões: Nos idosos incluídos neste estudo, a institucionalização associou-se a maior preocupação com quedas, menor capacidade funcional e menos queixas de dor. A prática de atividade física associou-se ao melhor desempenho no domínio capacidade funcional do questionário sobre qualidade de vida e à menor preocupação com quedas. DESCRITORES: idoso; saúde do idoso; institucionalização; qualidade de vida. ABSTRACT Aims:To assess the association of institutionalization and of the practice of physical activity with the fear of falling and the quality of life in elderly. Methods: Sixty-one elderly individuals were selected and classified into three groups: 21 institutionalized, 20 non-institutionalized active, and 20 non-institutionalized not active. The FES-I and the SF-36 questionnaires were used to evaluate fear of falling and quality of life, respectively. Participants were recruited in long term care facilities and among the elderly of the community, all residents of the metropolitan area of Florianópolis, Brazil. Data were analyzed using descriptive and inferential statistics (Anova One Way, Kruskal-Wallis test and Mann-Whitney) with a significance level p≤0.05. Results: No significant difference was found in the FES-I questionnaire among the institutionalized and non-institutionalized activ...

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How fear of falling can increase fall-risk in older adults: Applying psychological theory to practical observations

Cited by 277 publications

References 28 publications

Effect of Cervical Kinesthetic Motor Imagery on Postural Control of Healthy Young Adults with Fear of Falling

Effect of Cervical Kinesthetic Motor Imagery on Postural Control of Healthy Young Adults with Fear of Falling

Cognitively and socially induced stress affects postural control

Institucionalização e atividade física em idosos e suas relações com medo de cair e qualidade de vida

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