Fear of Falling Does Not Alter the Kinematics of Recovery From an Induced Trip: A Preliminary Study

Jane R Marone,Noah J Rosenblatt,Karen L Troy,Mark D Grabiner

doi:10.1016/j.apmr.2011.06.034

Jane R Marone, Noah J Rosenblatt + Show 2 more

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https://doi.org/10.1016/j.apmr.2011.06.034

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Abstract

Marone JR, Rosenblatt NJ, Troy KL, Grabiner MD. Fear of falling does not alter the kinematics of recovery from an induced trip: a preliminary study. Objective To provide preliminary information about the relationships between self-reported fear of falling (FOF) in healthy community-dwelling women, number of falls, and recovery kinematics in response to a laboratory-induced trip. Design Cohort study. Setting Clinical research laboratory. Participants A subset of community-dwelling older women (N=33) recruited from studies of laboratory-induced trips and fall prevention. Intervention A laboratory-induced trip. Main Outcome Measures Number of fallers in the FOF group versus the control group. Recovery kinematics of FOF group falls versus control group falls, and FOF group recoveries versus control group recoveries were compared. Degree of FOF was assessed by using the Activities-Specific Balance Confidence (ABC) Scale. Results Falls occurred in 6 of 14 (43%) FOF and 4 of 16 (25%) control subjects ( P=.26). The kinematics of FOF group falls were similar to those of control group falls. At completion of the initial recovery step, the FOF group showed significantly greater trunk extension velocity than controls (−82.1°/s±−66.1°/s vs −25.0°/s±−53.0°/s, respectively; P=.05). All other variables were not significantly different. ABC Scale scores of FOF subjects did not differ significantly between fallers and those who recovered (mean, 75.2±5.6, 71.1±11.8, respectively; P=.84). Conclusion Healthy community-dwelling older adults would benefit from fall prevention regardless of the presence of self-reported FOF.

Highlights

Fear of falling (FOF) affects approximately half of community-dwelling older adults.Prospective studies report an association between fear of falling (FOF) and increased number of falls in this population.[1,2] it is unclear how FOF contributes to falls
Subjects were classified as either FOF or control based on their response to the question, “Do you have any fear of falling that concerns you when you go about your daily activities?” multiple measurement techniques for FOF are reported in the literature, this direct question allowed us to estimate the prevalence of self-perceived FOF8 among a group of subjects willing to participate in a protocol which induces falls
With the exception of trunk angular velocity, which was significantly larger for FOF recoveries than for control group recoveries (p=0.05), between-group differences did not achieve significance for any of the variables

Summary

Introduction

Fear of falling (FOF) affects approximately half of community-dwelling older adults. Prospective studies report an association between FOF and increased number of falls in this population.[1,2] it is unclear how FOF contributes to falls. Gait adaptations to FOF do not appear to increase fall risk. Adults with FOF typically alter gait by decreasing velocity and step length,[3] which has been shown decrease the likelihood of a fall following a laboratoryinduced trip.[4] Trips may account for over 30% of community-occurring falls.[5]

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