Fear of falling, meaningful activity participation and community reintegration among stroke survivors in southwest Nigeria: a cross-sectional study

Abstract

Background/Aims Community reintegration remains one of the most important goals of rehabilitation. The aim of this study was to investigate the relationships between fear of falling, meaningful activity participation and community reintegration of community-dwelling stroke survivors. Methods The Fall Efficacy Scale-International, Engagement in Meaningful Activities Survey and Reintegration to Normal Living Index were used to assess fear of falling, meaningful activity participation and community reintegration respectively among self-ambulant stroke survivors receiving treatment in physiotherapy outpatient clinics. The study was a cross-sectional survey. Tests of relationships, regression and association were performed with a level of significance set at P<0.05. Results A significant relationship was found between fear of falling and community reintegration (r=−0.27; P=0.01; 95% confidence interval=−0.53 to 0.04); meaningful activity participation and community reintegration (r=0.72; P=0.001; 95% CI=0.48 to 0.89) and fear of falling and meaningful activity participation (r=−0.71; P=0.53; 95% CI=−0.32 to 0.24). Older participants had lower levels of community reintegration and meaningful activity participation. A significant association was found between fear of falling and fall history (P=0.02); increased falls meant higher levels of fear of falling. Sex and duration of stroke had no significant impact on fear of falling, meaningful activity participation and community reintegration. Meaningful activity participation was the strongest predictor of community reintegration (β=1.7; 95% CI=1.30 to 2.11; P=0.001). Conclusions Fear of falling might limit participation in meaningful activity and community integration among stroke survivors. These parameters should be assessed by allied health professionals during stroke rehabilitation.