The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis

Arnold, Catherine M.; Faulkner, Robert A.; Gyurcsik, Nancy C.

doi:10.3138/ptc.2010-29

Cited by 26 publications

(32 citation statements)

References 47 publications

(63 reference statements)

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“…This idea that physical capacity alone does not predict activity and participation post-stroke was shown in a study by Schmid et al 35 which found that self-efficacy impacts self-reported activity and participation in persons post stroke. 9 The impact of self-efficacy on activity and participation has also been shown in community dwelling manual wheelchair users aged 50 years or older 36 , individuals with hip osteoarthritis 37 , adults with arthritis 38 and women with fibromyalgia. 39 Research in other populations, including spinal cord injury, congestive heart failure, and knee osteoarthritis, also supports the role of self-efficacy as a mediator between performance and activity and participation domains.…”

Section: Discussionmentioning

confidence: 98%

Self-efficacy Mediates the Relationship between Balance/Walking Performance, Activity, and Participation after Stroke

French

Moore

Pohlig

et al. 2015

Topics in Stroke Rehabilitation

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Background Many outcome measures (OM) that assess individuals’ ability or beliefs in their ability to perform tasks exist to evaluate activity and participation after stroke; however, the relationship between various OM and activity/participation is unclear. Objective The purpose of this study was to explore the relationships between different OM and activity and participation in people after stroke. Methods 59 subjects post-stroke participated in an assessment including self-selected walking speed, 6 minute walk test, Timed “Up and Go” Test, Berg Balance Scale, Functional Gait Assessment, Walk 12, and Activity-specific Balance Confidence Scale. Step Activity Monitoring (SAM) was used as a measure of activity and Stroke Impact Scale-Participation (SIS-P) as a measure of participation. Exploratory Factor Analysis was performed including all measures except SAM and SIS-P. Two factors were extracted and termed performance based (PB) and self-efficacy (SE). A Path Analysis assessed the role of SE as a mediator in the relationships of PB and SAM/SIS-P. Results In the path analysis, PB significantly predicts SE (p < 0.001, b=0.44), but not SAM or SIS-P (p > 0.05, b=0.25 and b=0.11 respectively). SE significantly predicts both SAM and SIS-P (p < 0.001, b=0.46 and b=0.59 respectively). The Indirect Effects of PB on SAM and SIS-P were significant (p < 0.001; b=0.20 and b=0.26 respectively). Conclusion These results suggest that SE mediates the relationship between PB and activity and participation after stroke, reinforcing that improving activity and participation is more complicated than only targeting performance. Clinicians should administer SE and PB measures to determine the most accurate view of patients after stroke and seek to improve SE through interventions.

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Section: Discussionmentioning

confidence: 98%

Self-efficacy Mediates the Relationship between Balance/Walking Performance, Activity, and Participation after Stroke

French

Moore

Pohlig

et al. 2015

Topics in Stroke Rehabilitation

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“…22 In addition, older adults with hip OA and lower levels of falls efficacy responded better (i.e., with better physical performance and increases in falls efficacy) than those with higher levels of falls efficacy when education was combined with exercise. 23 Taken together, these findings suggest that older adults with hip OA are at an increased risk of falls as a result of combinations of physical and psychological fall-risk factors, and that interventions designed to address both types of factors should result in the greatest reduction of fall risk.…”

Section: Relationship Of Pain and Falls-efficacy To Balance And Walkingmentioning

confidence: 89%

“…6,7,[9][10][11][12][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] Although all 21 studies included adults with OA or joint pain (including hip and knee), only 14 were specific to either hip or knee OA. 10,11,12,16,19,[20][21][22][23][25][26][27][28][29] We found few studies that addressed the relationship between personal and environmental contextual factors and fall risk spe- Adapted from the Summary of the updated American Geriatrics Society/British Geriatrics Society clinical practice guideline for prevention of falls in older persons. BBS: Berg Balance Scale; TUG: timed up-and-go Test; ABC: Activities-specific Balance Confidence.…”

Section: Methodsmentioning

confidence: 99%

Risk Factors for Falls in Older Adults with Lower Extremity Arthritis: A Conceptual Framework of Current Knowledge and Future Directions

Arnold

Gyurcsik

2012

Physiotherapy Canada

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Purpose: As the numbers of Canadians aged 65 years and over increases over the next 20 years, the prevalence of chronic conditions, including arthritis, will rise as will the number of falls. Although known fall-risk factors are associated with hip and knee osteoarthritis (OA), minimal research has evaluated fall and fracture risk and/or rates in this population. Thus, the purpose was to summarize research on fall and fracture risk in older adults with hip or knee OA and to develop a conceptual framework of fall-risk screening and assessment. Method: The International Classification of Functioning, Disability and Health, clinical practice guidelines for fall-risk screening, and a selected literature review were used. Results: Gaps exist in our knowledge of fall and fracture risk for this population. Muscle performance, balance, and mobility impairments have been identified, but little is known about whether personal and environmental contextual factors impact fall and fracture risk. Physical activity may help to prevent falls, but non-adherence is a problem. Conclusion: A need exists to assess fall risk in older adults with hip and knee OA. Promoting regular physical activity by focusing on disease-and activity-specific personal contextual factors may help direct treatment planning.

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“…Four studies specifically used motivational interviewing (MI) as a main interventional strategy (Arkkukangas, Soderlund, Eriksson, & Johansson, ; Dorresteijn et al, ; Szanton et al, ). Seven studies used a small‐group‐based setting for their CBT‐based component, with group sizes ranging from 4–15 people (Arnold et al, ; Clemson et al, ; Freiberger et al, , ; Liu & Tsui, ; Tennstedt et al, ; Zijlstra et al, ). All study interventions included an exercise component in conjunction with CBT‐based strategies except for two studies.…”

Section: Resultsmentioning

confidence: 99%

Effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling among community‐dwelling older adults: A systematic review and meta‐analysis

Chua

Jiang

Lim

et al. 2019

Journal of Advanced Nursing

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Aims To systematically review the evidence and determine the effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling and falls among community‐dwelling older adults who are at risk of falling. Design A systematic review and meta‐analysis. Data Sources Six electronic databases, including CENTRAL, CINAHL, EMBASE, PubMed, PsycInfo and Scopus, were searched. Studies published in English from January 1998–July 2018 were included in this review. Review Methods Only randomized controlled trials addressing fear of falling and/or the occurrence of falls using cognitive behaviour therapy‐based multicomponent interventions were included. A standard procedure based on the Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias of the selected studies. A meta‐analysis was performed to determine the effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling immediately after the interventions, at ≤6 months and >6 months postinterventions. Results This review included 15 randomized controlled trials involving 3,165 community‐dwelling adults aged 60 years and older. The pooled results showed that the intervention effects, including immediate, short‐term (i.e., ≤6 months postintervention) and long‐term (i.e., >6 months postintervention) effects, favoured the intervention group. Conclusion Cognitive behaviour therapy‐based multicomponent interventions are effective at reducing fear of falling among community‐dwelling older adults who are at risk of falling. Impact Fear of falling has been implicated in activity restriction among older adults and fall prevention interventions need to be multifaceted. Understanding and attending to individual psychological needs are as important as exercise training.

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The Relationship between Falls Efficacy and Improvement in Fall Risk Factors Following an Exercise Plus Educational Intervention for Older Adults with Hip Osteoarthritis

Cited by 26 publications

References 47 publications

Self-efficacy Mediates the Relationship between Balance/Walking Performance, Activity, and Participation after Stroke

Self-efficacy Mediates the Relationship between Balance/Walking Performance, Activity, and Participation after Stroke

Risk Factors for Falls in Older Adults with Lower Extremity Arthritis: A Conceptual Framework of Current Knowledge and Future Directions

Effectiveness of cognitive behaviour therapy‐based multicomponent interventions on fear of falling among community‐dwelling older adults: A systematic review and meta‐analysis

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