Relationship Between Fear of Falling and Outcomes of an Inpatient Geriatric Rehabilitation Population—Fear of the Fear of Falling

Denkinger, Michael; Igl, Wilmar; Lukas, Albert; Bader, Anne Tobbe; Bailer, Stefanie; Franke, Sebastian; Denkinger, Claudia M.; Nikolaus, Thorsten; Jamour, Michael

doi:10.1111/j.1532-5415.2010.02759.x

Cited by 47 publications

(34 citation statements)

References 37 publications

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“…In addition, while the participants in our study were comparable to participants in other studies with respect to gender and type of fracture (7,12,25), FoF was assessed in vulnerable patients with hip fractures of very high age and with a high number of comorbidities. In particular, this group is in need of multidisciplinary rehabilitation (44) and at risk of FoF (16).…”

Section: Regression Analysis and Modelmentioning

confidence: 66%

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Fear of falling after hip fracture in vulnerable older persons rehabilitating in a skilled nursing facility

Visschedijk¹,

Caljouw²,

Balen³

et al. 2014

J Rehabil Med

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Objective: To identify factors that explain differences in patients with high and low levels of fear of falling after a hip fracture. Design: Cross-sectional study in 10 skilled nursing facilities in the Netherlands. Patients: A total of 100 patients aged ≥ 65 years admitted to a skilled nursing facility after a hip fracture. Methods: Participants were divided into 2 groups; low and high level of fear of falling, based on median Falls Efficacy Score -International. Data relating to factors that might explain fear of falling were collected, including demographic variables, aspects of functioning, psychological factors, and comorbidities. For every factor a univariate logistic regression was conducted. For the multivariate regression model a backward procedure was used in which variables with p < 0.05 were included. Results: Walking ability and activities of daily living before fracture, number of complications, activities of daily living after fracture, anxiety and self-efficacy were significantly associated univariately with fear of falling. Multivariate analysis showed that walking ability before fracture (odds ratio (OR) 0.34, 95% confidence interval (CI) 0.14-0.83), activities of daily living after fracture (OR 0.89, 95% CI 0.80-0.99), and anxiety (OR 1.22, 95% CI 1.05-1.42) were independently associated with fear of falling. Conclusion: Impaired walking ability before fracture, impaired activities of daily living after fracture, and increased anxiety help distinguish between older persons with high and low levels of fear of falling after hip fracture. Because the last 2 factors are modifiable, this information enables the development of specific interventions for older persons with a high level of fear of falling.

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Section: Regression Analysis and Modelmentioning

confidence: 66%

“…It is widely used and regarded as a suitable instrument for FoF (24). the impact of FoF is best illustrated by its role in predicting rehabilitation outcomes at discharge and follow-up (25). Reduction in FoF may therefore improve the outcomes of rehabilitation after a hip fracture.…”

mentioning

confidence: 99%

Fear of falling after hip fracture in vulnerable older persons rehabilitating in a skilled nursing facility

Visschedijk¹,

Caljouw²,

Balen³

et al. 2014

J Rehabil Med

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“…This could represent an important finding if patients changed behavior due to difference in fear of falling. Earlier studies have shown a strong correlation between FESI score and physical function in geriatric populations, (327) and it is likely that there is a similar relationship for FESI-s. On the other hand both CGC and OC had scores of FESI-s in the same level (9-13) indicating moderate risk of falling in both groups and therefore some degree of uncertainty of the clinical impact of our results. (289) FESI-s is sensitive in patients with low function, while it has a ceiling effect in high-function patients.…”

Section: Othermentioning

confidence: 88%

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

et al. 2015

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Bakgrunn: Hoftebrudd er en viktig årsak til sykdom og død med 1.3 millioner brudd årlig i verden og en fortsatt stigende insidens. Risikofaktorer er høy alder, osteoporose og skrøpelighet, og de fleste bruddene skyldes lav energitraumer på grunn av fall. Høy alder, nedsatt funksjon før bruddet og mannlig kjønn øker risiko for et uheldig resultat, mens fall utendørs er prognostisk gunstig.Utvikling av såkalt ortogeriatriske behandlingsmodeller for hoftebrudd som bruker teknikker og prinsipper utviklet i geriatrien er en måte å bedre prognosen for pasientene. Det er utviklet flere modeller:1. Konsultasjonsmodeller der pasienten på vanlig måte behandles i en ortopedisk avdeling, men får tilsyn og vurdering av geriater eller et geriatrisk team under oppholdet, og der teamet deretter foreslår tiltak til ortoped. 2. Modeller med felles ansvar der geriater og ortoped inngår i et team som utreder og behandler pasienten og legger en felles plan for videre oppfølging. 3. Geriatrisk team modeller der utredning og behandling (med unntak av selve kirurgien)foregår i en geriatrisk avdeling tilpasset bruddbehandling, og der ortopeder ansvarlig for operasjon, men ellers kun konsulteres ved behov. Målsetninger for studien: Overordnet mål for studien var å undersøke om bred geriatrisk utredning og behandling (CGC) ga en tilleggsgevinst sammenlignet med tradisjonell ortopedisk behandling (OC).Målsetninger for denne avhandlingen er:1. Å beskrive bakgrunn, utvikling og prinsippene bak de orthogeriatriske modellen og hvordan den skiller seg fra vanlig behandling (Artikkel I). 2. Å presentere kliniske resultat (Artikkel II): a. Mobilitet fire måneder etter bruddet (primaert endepunkt) b. Sekundaere endepunkt: i. Mobilitet etter en og 12 måneder, og p-i-ADL, kognisjon, frykt for å falle, stemningsleie og livskvalitet en, fire og 12 måneder etter bruddet, ii. Bruk av helsetjenester første året etter bruddet 3. Finne ut om effekten på mobilitet, p-og-i-ADL og kognisjon var avhengig av alder, kjønn, bruddtype og funksjon før bruddet (Artikkel III).Metode: Hoftebruddsstudien i Trondheim er en randomisert kontrollert studie basert på ortogeriatrimodell 3 ovenfor. Studien sammenligner standard ortopedisk behandling (OC) med ortogeriatrisk behandling i en egen enhet (CGC). Hjemmeboende pasienter 70 år eller eldre som klarer å gå minst 10m og som har et lavenergibrudd kunne inkluderes, mens pasienter fra sykehjem, høy-energi brudd, patologisk fraktur eller annen sykdom med forventede leveutsikter på mindre enn 3 måneder ble ekskludert. Behandlingen er basert på bred geriatrisk utredning (CGA) og gjennomføres av et tverrfaglig team bestående av geriater (overlege eller lege i spesialisering), sykepleier, fysioterapeut og ergoterapeut; teamet har regelmessige møter der det lages individuelle behandlingsplaner og settes mål for opphold og klargjør videre behov etter utreise samt behandlingsmål. Behandlingen er helhetlig og fokuserer på tidlig mobilisering, gjennomgang av den enkelte pasient med tanke på bakenforliggende sykdom, medisingjennomgang...

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“…Literature states that exposure to FoF contributes to a loss of independence or disability through the restriction of activities [21,22] since it is associated with an increased risk of functional decline [23], reduced physical activity, lower perceived physical health status, lower quality of life and increased institutionalization [24]. Despites being more frequent among fallers, FoF and activity restriction are not exclusive of these persons.…”

Section: Fear Of Fallingmentioning

confidence: 99%

Multifactorial Screening Tool for Determining Fall Risk in Community-Dwelling Adults Aged 50 Years or Over (FallSensing): Protocol for a Prospective Study (Preprint)

Martins¹,

Moreira²,

Silva³

et al. 2018

Preprint

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Background: Falls are a major health problem among older adults. About a third of community-dwelling adults aged 65 years or over fall each year. The risk of falling can be increased by polypharmacy, vision impairment, high blood pressure, environmental home hazards, fear of falling and changes in function of musculoskeletal and sensory systems, associated with aging. Moreover, individuals who experienced previous falls are at higher risk. Nevertheless falls can be prevented by screening to detect risk factors. Objective: To understand if FallSensing screening tool is able to determine the fall risk of community-dwelling adults aged 50 years or over. Methods: FallSensing screening tool is a technological solution for fall risk screening, including a software, a pressure platform and two inertial sensors. The screening software includes questions about sociodemographic and health and lifestyle behaviors, a detailed explanation about procedures to accomplish six functional tests (Grip Strength, Timed Up and Go, 30 seconds Sit-to-Stand, Step test, 4 Stage Balance test "modified" and 10 meters Walking Speed) and three questionnaires concerning environmental risk, activities and participation profile related to mobility and self-efficacy for exercise. The questions registers information about demographic and anthropometric data (age, sex, height and weight), Fear of Falling, history of fall (previous 12 months), health conditions, medication, sedentary lifestyle, upper extremities assistance to stand from a chair, living settings, alcohol habits, self-perceived health and unintentional or involuntary weight lost. We will recruit community-dwelling adults aged 50 years or over, independent to be standing and walking with or without walking aids in different regions of continental Portugal. In order to be a representative sample of Portuguese population, a minimum of 385 participants is needed. Results: The development of the FallSensing screening tool started in October 2015, and the screening of participants started in June 2016 and continues by the time of submission. A set of seniors' university, parish councils, physical therapy clinics and other community facilities have consented to participate in the study. Conclusions: In order to develop a multifactorial screening tool for fall risk in community-dwelling adults, it is essential to identify key risk factors for falls and select the best method to evaluate them. FallSensing screening tool, gathers a multifactorial assessment, designed and studied through the best evidence, which seek to identify factors that influence the fall risk. Understanding these factors, will allow that preventive strategies could be implemented and decrease falls rates.

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Relationship Between Fear of Falling and Outcomes of an Inpatient Geriatric Rehabilitation Population—Fear of the Fear of Falling

Cited by 47 publications

References 37 publications

Fear of falling after hip fracture in vulnerable older persons rehabilitating in a skilled nursing facility

Fear of falling after hip fracture in vulnerable older persons rehabilitating in a skilled nursing facility

Comprehensive geriatric care for patients with hip fractures: a prospective, randomised, controlled trial

Multifactorial Screening Tool for Determining Fall Risk in Community-Dwelling Adults Aged 50 Years or Over (FallSensing): Protocol for a Prospective Study (Preprint)

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