CrossTalk proposal: Fear of falling does influence vestibular-evoked balance responses.

Abstract

Fear of falling (FoF) is an autonomic, cognitive and behavioural response to a real or imminent threat of a fall (Hadjistavropoulos et al. 2011). Given its multidimensional nature, the assessment of fear usually relies on self-report and converging evidence from a number of independent but related measures, such as anxiety (Davis et al. 2010), confidence (self-efficacy) and arousal (Hadjistavropoulos et al. 2011). Recent studies, in which young healthy adults have been exposed to a postural threat (e.g. standing on an elevated platform where the consequences of a fall are severe), have shown that fear and related factors directly affect control of quiet standing and dynamic balance responses (Brown & Frank, 1997; Carpenter et al. 2001, 2004; Sibley et al. 2010); however, the mechanisms underlying these fear-related postural changes are yet to be understood fully. Of recent debate is whether FoF-related changes in vestibular function, as evidenced by modulation (or lack thereof) of vestibular-evoked balance responses, might contribute to threat-related adjustments in balance behaviours (Osler et al. 2013; Horslen et al. 2014). Our position is that FoF does influence vestibular-evoked balance responses.