Fear of Falling in Subacute Hemiplegic Stroke Patients: Associating Factors and Correlations with Quality of Life

Abstract

ObjectiveTo determine the associating factors of fear of falling (FOF) and the correlations between FOF and quality of life (QOL) on subacute stroke patients in Korea.MethodFifty hemiplegic subacute stroke patients in our clinic were recruited. We directly asked patients with their fear of falling and interviewed them with the Korean version of falls efficacy scale-international (KFES-I). We divided the participants into two groups; with FOF and without FOF. We compared these groups with the strength of hemiplegic hip abductor, knee extensor, ankle plantar flexor, functional ambulation category (FAC) scale, stroke specific quality of life (SSQOL), and hospital anxiety depression scale (HADS).ResultsThirty-four participants were enrolled, and more than half of the patients with subacute stroke had FOF. We compared the patients with and without FOF. According to the results, FOF was associated with the strength of hemiplegic hip abductor, knee extensor and ankle plantar flexor, FAC, total SSQOL, and domains (energy, mobility, self care, upper extremity function) of SSQOL (p<0.05). FOF was also associated with the anxiety score of HADS (p<0.05). KFES-I had a significant negative correlation with the strength of hemiplegic hip abductor, knee extensor and ankle plantar flexor, FAC, total SSQOL, and domains (energy, mobility, self care, upper extremity function) of SSQOL (p<0.01).ConclusionThe FOF was associated with not only QOL but also with the physical and psychological factors, and in particular, anxiety. Therefore, further concerns about FOF in subacute stroke patients might be required.

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

“…As this is the first study to use multivariable analyses to investigate determinants of FOF in persons with late effects of polio, our results are difficult to compare with others. However, in persons with other neurologic diseases, such as stroke and Parkinson disease, decreased balance [33], muscle weakness in the lower limbs [27], and walking limitations [24,34] have been shown to be associated with FOF.…”

“…The FES‐I score also can be categorized as low FOF (16‐19 points), moderate FOF (20‐27 points), or high FOF (28‐64 points) [23,24]. The FES‐I has shown good psychometric properties [25] and is used commonly in persons with different neurologic and neuromuscular diseases [10,14,15,24,26,27].…”

Effects of hip abduction and adduction accuracy on post-stroke gait

“…Interventions could then be targeted to the underlying causes, allowing both a mechanistic approach and patient-specific treatment. As an example, lower extremity muscular weakness has been linked to fall risk and fear of falling [Mackintosh et al 2006; Kim et al 2012]. Therefore, strengthening interventions may improve gait stability in stroke survivors with this limitation.…”

Falls and Fear of Falling After Stroke: A Case‐Control Study

“…It has been hypothesized that fear of falling limits patients' mobility, which in turn leads to further deterioration in physical function (balance, strength, and endurance) and leads to falling [19,20]. In addition to its effects on falls, fear of falling is also associated with anxiety [20], poor community reintegration [21], and poor quality of life [22]. Hence, understanding the development of fear of falling after stroke is critical to disrupt the vicious cycle between fear of falling and falls in stroke survivors.…”