Falls Efficacy Scale-International Research Articles

Cross-cultural adaptation, validity and reliability of the Tamil version of the Falls-Efficacy Scale – International in Indian elderly population

Background. Fall Efficacy Scale - International (FES-I) is a validity and reliability measure used to assess fear of fall. However, it is worth noting that FES-I is currently not available in the Tamil language. Therefore, the objective of this particular study was to cross-culturally adapt the measure into Tamil and subsequently test the validity and reliability of the translated version. Methods. The original English version of FES-I was translated according to the protocol set by ProFaNE. The Tamil version, FES-I (T), was given to 81 elderly Tamil-speaking participants. Statistical analyses were done to compare groups based on age, gender, fear of falling, and fall history. The validity of FES-I (T) was assessed by comparing its scores with the TUG test and SPPB. The reliability of FES-I (T) was evaluated using the Intraclass correlation coefficient. Results. The total scores obtained from FES-I (T) exhibited a positive correlation with the scores obtained from the TUG test (rs = 0.584), while displaying a negative correlation with the scores obtained from the SPPB (rs = −0.619, p-value < 0.001). Furthermore, the test-retest reliability of FES-I (T) was found to be excellent, with the Intraclass correlation coefficient for the total score recording a value of 0.99. Conclusion. Based on the findings of this study, it can be concluded that the FES-I (T) is a valuable tool that can be effectively utilized in both clinical practice and research settings to assess fear of falling in elderly individuals who speak Tamil.

Comparing Sensitivity, Specificity, and Accuracy of Fall Risk Assessments in Community-Dwelling Older Adults.

The US Centers for Disease Control and Prevention (CDC) has implemented the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative. This initiative provides an algorithm for fall risk screening. However, the algorithm has the potential to overcategorize individuals as high risk for falling upon initial screening, which may burden clinicians with the task of recategorizing individuals after follow-up testing. Therefore, this study aimed to compare the accuracy, sensitivity, and specificity of fall risk appraisal between the STEADI, Short Fall-Efficacy Scale International (FES-I), and portable balance system (BTrackS) assessments in community-dwelling older adults. This cross-sectional analysis included 122 community-dwelling older adults, comprising 94 women and 28 men. Center-of-pressure postural sway was assessed using the BTrackS, fear of falling was assessed using the Short FES-I questionnaire, and all participants completed the STEADI checklist. Each assessment categorized participants as either high or low fall risk and fall risk appraisal was compared between groups using McNemar tests. The STEADI checklist (high risk: n = 62; low risk: n = 60) significantly differed in fall risk appraisal compared to the BTrackS (high risk: n = 44; low risk: n = 78; p = 0.014) and the Short FES-I (high risk: n = 42; low risk: n = 80; p = 0.002). Compared to the BTrackS, the STEADI checklist had a specificity of 62.8%, sensitivity of 70.5%, and accuracy of 65.6%. Compared to the Short FES-I, the STEADI checklist had a specificity of 67.5%, sensitivity of 81.0%, and accuracy of 72.1%. The STEADI checklist appears to overcategorize individuals as high fall risk more frequently than direct assessments of postural sway and fear of falling. Further research is needed to examine potential improvements in accuracy when combining the STEADI checklist with direct assessments of postural sway and/or fear of falling.

Determining the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. Difficulty of older adult to aging.

To determine the predictors associated with the difficulty of adaptation to ageing of hospitalized older adults. This descriptive cross-sectional study was carried out in a university hospital between October 2019 and March 2020. The sample consisted of 247 older adults. Research data were collected using a Visual Analogue Scale (VAS), the Falls Efficacy Scale (FES) International, Hospital Anxiety and Depression Scale, and Assessment Scale of Adaptation Difficulty for the Elderly (ASADE). The average age of the patients was 73.90 ± 7.38 years, 22.3% of the patients had a fall history in the last year, and 74.5% had a high fear of falling. The mean FES score of the older adult patients was 35.60 ± 11.09, and the mean VAS score was 1.40 ± 1.36. The mean scores for anxiety was 9.30 ± 2.32 and depression was 10.08 ± 1.96. The mean ASADE total score was 16.56 ± 10.7, role and the self-actualization mode score was 9.05 ± 4.66, interdependence mode score was 2.02 ± 1.02, physiological mode score was 3.00 ± 2.03 and self-concept score was 2.47 ± 2.07. The findings revealed that using walking aids, being single, pain, fear of falling, and anxiety affect adaptation difficulties to aging. Anxiety was found to have an effect on all sub-dimensions of adaptation difficulty to aging. There is a need for further studies to determine the correlation between anxiety and the adaptation difficulties experienced by older adults.

The effect of CLOSER-computer-based exercise program in older adults with a history of falls: a pilot study

ABSTRACT CLOSER is a computer-based exercise program that aims to improve older adults’ health, fitness and social lives. This pilot study aimed to examine the effect of CLOSER, the first computer-based exercise program developed for older adults on a national scale, on those with a history of falls. Forty-eight older adults (71.33 ± 7.47) with a history of falling at least once in the last year were included in the study. Older adults performed CLOSER exercises for (balance maintenance, neck rotation, rhythmic walking, knee flexion and trunk rotation) 2 sessions per week for eight weeks. All individuals were evaluated at baseline and the end of the eighth week. The primary outcome measures were the 30-s Chair-Stand Test (p = 0.002), the Berg Balance Scale (p = 0.002), the Falls Efficacy Scale International (p = 0.003), the Timed Up and Go Test (p = 0.008) and the motivation level (p = 0.007) statistically significant improvements were observed. The results show that a CLOSER-computer-based exercise program effectively increases balance and reduces the risk and fear of falling. In the future, CLOSER could significantly contribute to the healthcare system as an alternative aid for home-based exercise.

Associations between the Falls Efficacy Scale International (FES-I) and poor strength and balance in community-dwelling older people

Associations between the Falls Efficacy Scale International (FES-I) and poor strength and balance in community-dwelling older people

Translation and Psychometric Analysis of Activities Specific Balance Confidence Scale (Abc-U) and Fall Efficacy Scale International (Fes-I-U) in Elderly

Background: With the increasing elderly population globally, understanding and managing fear of falling and balance issues have become paramount, especially in countries like Pakistan. The Activities-specific Balance Confidence (ABC) scale is a widely recognized tool for assessing these concerns in older adults. However, there was a need for a version adapted to the Urdu-speaking population. Objective: The study aimed to translate the ABC scale into Urdu and assess its psychometric properties to provide a reliable tool for evaluating fear of falling and balance confidence in Pakistani older adults. Methods: This analytical study involved a sample of 120 elderly individuals, selected through non-probability convenience sampling from PAF Hospital Islamabad and local communities. Inclusion criteria were individuals aged 60 years or above, capable of walking with or without aid, and proficient in Urdu. Those with known pathologies affecting balance, psychological issues, vision impairments, or a history of fractures were excluded. The English version of the ABC scale was translated into Urdu following the COSMIN guidelines. Psychometric testing included evaluating internal consistency, test-retest reliability, and concurrent validity. Data analysis was performed using SPSS version 25. Results: The Urdu version of the ABC scale showed high internal consistency (Cronbach's alpha > 0.90). The Standard Error of Measurement (SEM) for the complete tool was 2.40, with individual components ranging from 3.55 to 11.2. The Minimal Detectable Change (MDC95) for the full scale score was 6.4. Concurrent validity, assessed through correlation with the Fall Efficacy Scale International Urdu version (FES-I-U), revealed a strong negative relationship (r = -0.80, p < 0.0001). The mean normative value of self-perceived balance confidence among participants was 70.5. Conclusion: The study successfully translated and validated the ABC scale into Urdu, providing a reliable and valid tool for assessing fear of falling and balance confidence among Urdu-speaking older adults in Pakistan. This adaptation is crucial for culturally sensitive geriatric care and fall prevention strategies.

Cross-cultural adaptation, reliability, and validity study of the Turkish version of the “Spinal Cord Injury-Falls Concern Scale”

Purpose This study aims to conduct a Turkish validity and reliability study of the Spinal Cord Injury-Falls Concern Scale (SCI-FCS). Methods The study involved 134 volunteer patients with spinal cord injury. Various validity analyses, including content validity analysis, Confirmatory Factor Analysis (CFA), Pearson product-moment correlation coefficient, and Cronbach’s alpha value based on a single application for reliability, were employed. The Falls Efficacy Scale-International (FES-I) was used for criterion validity. Results All the standardized regression coefficients for the single factor measurement model established with 16 items in the scale are above 0.84. The CFA model, also with a single factor and 16 items, yields the following fit indices: Root-Mean-Square Error of Approximation value of 0.15, Standardized Root Mean Residual Squares value of 0.06, Chi-square value of 2.20, and Comparative Fit Index and Non-Normed Fit Index values of 0.98. The scores they received from the SCI-FCS and the scores they received from the FES-I scale have a statistically significant positive correlation (p < 0.01). The test-retest reliability coefficient value is 0.81, and the Cronbach Alpha value is 0.97. Conclusion The Turkish version of the SCI-FCS is a valid and reliable tool for determining fall concerns for patients with spinal cord injury.

The Effectiveness of Toe Flexor Strengthening on Balance and Risk of Fall in Patients with Diabetic Polyneuropathy- A Pilot Study

Background:Diabetic polyneuropathy (DPN) is relatively common complication of long-term diabetes and isthought to be progressive and irreversible. The loss of sensations associated with Diabetic polyneuropathy isthought to contribute to impaired balance and increased risk of falling. Reduced toe flexor strength is an independentpredictor of falls. However, it is unknown whether strengthening programs can restore toe flexorstrength in patients with DPN.The aim of this study was to investigate whether a progressive resistance training program, focused specifically on the foot &amp; toe flexor muscles, could improve toe flexor strength in patients with DPN.Methods: A total of 20 patients were allocated into two groups of 10 each. Group A receive 12 sessions of (Conventional physiotherapy &amp; Modified toe training programme) and Group B (Conventional physiotherapy &amp; General toe exercise). Berg balance score (BBS), Fall efficacy scale international (FES-I) &amp; Time up and go test (TUG) were measured on first day (Week 1) and last day (Week 4) of intervention. Pre-test and post-test scores were compared and results were tabulated.Result: Both groups showed significant improvement in balance performance. The Group A showed statistically significant improvement in static &amp; functional balance when compared to Group B.Conclusion: The study demonstrated a significant improvement in balance and functional mobility was seenamong Group A.

Multiple Long-Term Conditions and Disability are Independently Associated with Higher Risk of Fall Among Community Adults: a Cross-Sectional Study.

Previous studies have suggested an association between falls and the presence of Multiple Long-Term Conditions (MLTC) or disabilities. However, there is limited understanding of how these factors independently or collectively contribute to the risk of falls and fear of falling among community-dwelling adults. This study examined the independent association between MLTC and the presence of disability with the risk of falls among community adults. A cross-sectional study included 324 adults (age ≥ 50). Demographic and clinical data included age, sex, body mass index (BMI), MLTC (≥ two chronic diseases) risk of fall (ie, history of fall in the previous 12-months, number of falls, and recurrent falls). The Barthel Index and Falls Efficacy Scale-International (FES-I) were used to assess disability and fear of fall, respectively. MLTC (Odds Ratio (OR) 2.50, 95% Confidence Interval (CI) [1.26, 4.95], p=0.009), and disability (OR 1.71, 95% CI [1.04, 2.79], p = 0.034) were independently associated with history of falls. MLTC (Incidence Rate Ratio (IRR) 2.87, 95% CI [1.93, 4.29], p < 0.001) and disability (IRR 1.86 95% CI [1.46, 2.36], p < 0.001) were independently associated with an increased number of falls. MLTC (OR 4.50, 95% CI [1.78, 11.36], p = 0.001) and disability (OR 2.82, 95% CI [1.58, 5.05], p < 0.001) were independently associated with recurrent falls. MLTC (B = 6.45, p < 0.001) and disability (B = 3.05, p = 0.025) were independently associated with increased fear of falling. This study indicated that both MLTC and disability are independently associated with falls, number of falls and fear of falling in this population.

Sarcopenia, but not malnutrition, is associated with fear of falling in older patients with dementia.

Fear of falling (FoF) is common in patients with cognitive impairment. However, the role of sarcopenia and malnutrition, which are two important factors that cause falls, on FoF is unknown. The aim of this study was to explore the association between FoF and malnutrition and sarcopenia in older patients with dementia. Two hundred and sixty-six dementia patients underwent comprehensive geriatric assessment. The Falls Efficacy Scale-International (FES-I) was applied to assign and classify FoF. Scores for the FES-I scale were categorized as ≥28, 20-27, or 16-19, representing high concern, moderate, and no or low concern about FoF, respectively. Mini Nutritional Assessment (MNA) scores <17, 17-23.5, or >23.5 were categorized as malnutrition, malnutrition risk, and well-nourished, respectively. Sarcopenia was defined using the SARC-F tool. SARC-F score ≥4 was categorized as sarcopenia. Serum folate, Vitamin B12, and Vitamin D deficiencies were also evaluated. The relationship between FoF groups and nutritional status, presence of sarcopenia, and micronutrient status was evaluated. The mean age was 80.83±6.61 years. The prevalence of moderate and high FoF in dementia patients was 51%. There was a significant difference in terms of cerebrovascular events, the history of falling, instrumental and basic activities of daily living (IADL and BADL), MNA, and SARC-F scores between the FoF groups (p<0.05). The association between sarcopenia and FoF persisted in multivariable analysis adjusted for MNA scores, cerebrovascular events, falls history, BADL, and IADL (OR=2.67, 95% CI: 1.50-4.50), but there was no significant association between malnutrition/micronutrient deficiencies and FoF (p>0.05). Sarcopenia is associated with the severity of FoF, but malnutrition or micronutrient deficiencies are not associated with the severity of FoF in older patients with dementia.

Association between walking speed reserve and fear of falling in stroke survivors

Objective: Stroke survivors may have residual mobility impairments and an inability to improve walking speed in daily life and can result in falls, one of the most common complications after a stroke. The ability to improve walking speed is determined by the difference between the fast and self-selected walking speed, the walking speed reserve (WRS). So, the objective is to investigate the relationship between the WRS capacity and the fear of falling in stroke survivors. Methods: This is a cross-sectional study with fifty five stroke survivors. The WRS was determined by the 10 meter walk test (10MWT, in m/s), and the fear of falling was assessed by Falls Efficacy Scale International (FES-I in points). Pearson’s correlation was used to investigate the association between the WRS and fear of falling. Results: 54.5% were male, with a mean age of 62.5 (SD 14.9) years and 41% were community walkers (≥0.8m/s). The WRS was 0.17±0.17m/s, and the mean FES-I score was 31.79±9.88. A negative and statistically significant association was found, with a reasonable magnitude between the WSR and the FES-I score (r= -0.38; p= 0.005). Conclusion: Stroke survivors who have greater WSR capacity, have a lower score on the FES-i scale, indicating less fear of falling.

SENIOR TECHNOLOGY ACCEPTANCE, FEAR OF FALLING AND FALL RISK ASSESSMENT IN COMMUNITY-DWELLING OLDER ADULTS

Abstract The use of technology, such as the BTrack balance system (BBT) for fall risk assessment and the Senior Technology Acceptance (STA) survey is important for understanding technology-based fall prevention efforts for at-risk older adults. The purpose of this study was to examine the relationship between technology-based fall risk assessment and STA among community-dwelling older adults aged 60 years and older (n=124). Descriptive statistics, bivariate analysis, and multiple linear regression adjusted for socio-demographics were performed. The STA tool was used to obtain information about older adults’ acceptance of technology. The STA consists of four domains and 14 items. The Short Fall Efficacy Scale International (FES-I) and the BBT were used to measure fear of falling and balance performance, respectively. Of the study population, 77.4% were female, 22.6% were non-white, 8% reported financially inadequate, 46% had low BBT scores and low FES-I scores, whereas 33.9% had high BBT and high FES-I scores, and 20.2% had low BBT and high FES-I scores. For the bivariate analysis, we found a statistically significant difference in the STA scores based on age (p=0.006) and education (p=0.032). In the adjusted analysis, only age was negatively associated with the STA (p=0.004); fall risk assessment using the BBT and FES-I were not significantly associated with STA. With a small study population, readers should be aware of this limitation to our findings. Further studies are needed to address this issue and to identify effective strategies to encourage older adults to use technology to improve their well-being.

FALL RISK AND FEAR OF FALLING IN LOW-INCOME COMMUNITY-DWELLING OLDER ADULTS USING A SIMPLE CHECKLIST

Abstract Fall risk is common among older adults and can seriously threaten their well-being and increase fear of falling (FOF). FOF can affect the ability of older adults to maintain daily activities and may cause depression. Using a simple checklist to assess the levels of fall risk and FOF can help tailor interventions to prevent falls and promote physical activity. The purpose of the study was to assess fall risk and FOF using simple checklists and examine the association between fall risk and FOF in community-dwelling older adults in low-income settings. A descriptive cross-sectional design was used to assess 103 older adults (men=16, women=87, mean age=75.70, SD±7.19). We used the CDC’s Stay Independent checklist with twelve items to measure fall risk and the Short Fall Efficacy Scale International (Short FES-I) with seven items to assess FOF. Scores equal to or greater than four on the Stay Independent and greater than ten on the Short FES-I indicate high fall risk and high FOF, respectively. The data was analyzed using SPSS version 28. Spearman correlation tests showed that fall risk was positively correlated with FOF (r=.606, p&amp;lt;.001). Our finding suggests that using simple checklists to assess both fall risk and FOF may be helpful for older adults in understanding their risk of falls, thus attenuating their FOF. It may be useful to increase accessibility to these two checklists in efforts to prevent falls and FOF among community-dwelling older adults in low-income settings.

FEAR OF FALLING PREDICTS NEGATIVE PERCEPTIONS OF AGING AMONG LOW-INCOME COMMUNITY-DWELLING OLDER ADULTS

Abstract Negative self-perceptions of aging (NSPA) are associated with various health-related outcomes, including fear of falling (FOF). Despite the leading cause of injury, disability, and hospitalization among racially diverse low-income older adults, FOF’s predictive potential effect on NSPA is less studied. This was a cross-sectional study with a sampling of 54 independent and cognitively healthy older adults (4 males, 47 females, mean age 73.91, SD: 6.4; 61-87 years old) in a low-income community. A five-item NSPA Likert scale, part of the Brief Ageing Perceptions Questionnaire (B-APQ), was used to assess the negative self-perceptions of aging, with higher scores indicating fewer negative views. The Short Fall Efficacy Scale International questionnaire was used to evaluate the level of concern about falls for a range of activities of daily living. More than half of the participants were African Americans (27 or 50%), completed high school (29 or 53.7%), lived alone (37 or 68.5%), and earned just enough financially (29 or 53.7%). The simple regression results indicated that the model explained 14.9% of the variance (R2=.149, F(1,52) = 9.13, p =.004). Fear of falling (FOF) (β = -.406, p =.004) was negatively associated with NSPA. As FOF scores increased, NSPA scores decreased, signifying higher FOF, accentuating worse perceived aging. Future longitudinal research should focus on the relationship between FOF and NSPA in increasing fall risk and injurious falls, especially in ethnically diverse low-income older adults, to further clarify this relationship and its consequences. Additionally, assessing FOF and providing interventions may enhance positive perceptions of aging.

OCCUPATIONAL THERAPY INTERVENTIONS TO IMPROVE OCCUPATIONAL PARTICIPATION AND REDUCE THE RISK OF FALLS IN ELDERLY PEOPLE WITH OSTEOARTHRITIS

Global trends show an increase in life expectancy. A similar trend in life expectancy growth is typical for Ukraine. However, even a positive trend towards an increase in average life expectancy cannot stop the inevitable process of aging, which leads to a decrease in the functional and physiological capabilities of all body systems.&#x0D; Osteoarthritis is the most common disease of elderly. Osteoarthritis of the joints of the lower extremities is a risk factor for falls syndrome. Falls lead to a decrease in physical functioning, independence and occupational participation, increase the fear of the next fall, and bring serious injuries, even depth. The role of an occupational therapist in falls prevention is undeniable. It helps maximize the ability to participate in the occupational activity that is meaningful to the client, and modifies the client's lifestyle and living environment for safe occupational performance.&#x0D; The aim of the research. To scientifically justify and develop a comprehensive program of occupational therapy interventions to reduce the risk of falls for elderly women with osteoarthritis of the lower extremities by means of occupational therapy.&#x0D; Materials and methods. In order to fully solve the tasks and study the activity of elderly women with osteoarthritis of the joints of the lower extremities, the following research methods were chosen: analysis of special and scientific and methodical literature; content analysis of medical records, interviews, observations; WOMAC Osteoarthritis Index and assessment of fear of falling according to Falls Efficacy Scale International.&#x0D; 48 women aged 62 to 89 took part in the ascertainment experiment. Women were divided into 2 groups - main (MG) and control (CG), 24 people in each. The main group included women with osteoarthritis of the lower extremities. In the control group people were without damage to the joints. The program lasted for 6 (six) months. The people of CG received recommendations about general physical activity with reference to WHO guideline. The people of MG received therapeutic exercises on strength, balance, coordination, endurance, improvement of walking skills and occupational therapy interventions with: training to perform occupations safely; creation of a new stereotype of behavior to avoid falling; modification of the environment; review of medications which can provoke a fall; learning to use assistive equipment; techniques to get up safely and effectively after a fall.&#x0D; Research results. Based on the obtained data, it is evident that both groups experienced an increase of independence level in functioning, less of pain, stiffness and fear of falling.&#x0D; Conclusions. Both falling and the fear of falling significantly reduce the ability to lead a full and independent life, bring undesirable consequences, including serious injuries, and interfere with the ability to do what is most important for a person. In the foreign literature, there is a lot of evidence about the contribution of occupational therapy to the prevention of falls. The results of the conducted research give grounds for asserting that the application developed by us a multi-component program of occupational therapy interventions developed for elderly people with osteoarthritis of the joints of the lower extremities is an effective means of reducing the risk of falls in this category of people. The advantages of the developed program are confirmed by the results of own research.

Implementation of a Multicomponent Otago-Based Virtual Fall Reduction, Education, and Exercise Program (MOVing FREEly) in Older Veterans.

The COVID-19 pandemic limited access to community fall prevention programs, thus establishing the need for virtual interventions. Herein, we describe the feasibility, effectiveness, and acceptability of a virtual, multicomponent fall prevention program (MOVing FREEly). A team of clinical falls prevention experts developed a six-week multicomponent fall prevention exercise and education class for older community-dwelling adults at risk of falling. Feasibility was measured through class attendance; effectiveness was measured through changes in performance measures, self-report of falling risk, and concern about falling; acceptability was assessed through questionnaires completed immediately upon program completion and at a three-month follow up. A total of 32 patients participated in the MOVing FREEly program. Attendance for education and exercise classes on average was greater than 80% with little attrition. Patient reported reduced concern of falling, improvement in the falls efficacy scale-international (FES-I) short form, and had statistically significant improvement in 30 s sit-to-stand and single-leg balance tests. The program was well received by participants, saving them significant time and costs of travel. A virtual, multicomponent fall prevention program is feasible and acceptable and effective as reducing falling risk. Future studies can explore the ability of this program to reduce falling incident and injury.

Sedentary behaviour and related factors in people with multiple sclerosis

BackgroundSedentary behaviour is a major problem in persons with multiple sclerosis (pwMS). However, little is known about the related factors of sedentary behaviour in MS. Our study aimed to examine the association between sedentary behaviour and physical activity level, fear of falling, and fatigue. MethodDemographic and clinical data have been recorded. Sedentary behaviour was assessed with the Marshall Sitting Questionnaire, physical activity level was evaluated with the Godin Leisure Time Exercise Questionnaire, fear of falling was evaluated with the Fall Efficacy Scale International, and fatigue was evaluated with the modified fatigue impact scale (MFIS). The Timed 25-Foot Walk, 6-Minute Walk Test, Timed Up and Go Test, and 12-Item Multiple Sclerosis Walking Scale were also used to assess walking and perceived walking disability. ResultsWe recruited 71 pwMS [49 were female (69 %), mean age:38.08 years, median EDSS:1.5]. The mean daily sitting time was 593.54 min (∼10 h). No significant correlation was found between sitting times and demographics, leisure time physical activity, fear of falling, walking, perceived walking disability, and neurological disability level (p > 0.05). Logistic regression analysis indicated that being male increased the risk of sedentary behaviour by 3.08 times, being employed increased the risk of sitting by 4.65 times, and each point increase in MFIS scores resulted in a 1.03-fold elevation in the odds of prolonged sitting. ConclusionThe fact that pwMS, even with a mild disability spend almost 10 h sitting highlights the significance of sedentary behaviour in this population. Developing strategies to address modifiable factors, such as fatigue, may be effective in reducing sedentary behaviour.

Older Adults: Comparing Traditional Exercise to an Interactive Technology Training

Aims This study compared the effect of traditional exercise training and game-based exercise by TRAZER© on dynamic balance activities, vestibular ocular motor sensory (VOMS), falls efficacy scale-international (FES-I), and muscular performance in healthy older adults. Methods Twenty-two older adults (mean age: 77.59 ± 6.20 years) randomly divided into two groups (1) exercise training (ET) and (2) ET + TRAZER©. Both groups participated in one-hour exercise sessions, three days a week for 10 wk. The ET + TRAZER© group completed the three dynamic/agility balance assessments each day. Results The results showed the three TRAZER© assessments significantly increased in the ET + TRAZER© group. However, there was not a statistically significant difference between the groups for timed up and go (TUG), sit-to-stand (STS), and FES-I. Conclusions Our findings provided evidence that game-based exercise intervention improved muscular function and VOMS, especially dynamic balance and reaction time in older adults.

Predictors of Dizziness and Hearing Disorders in People with Long COVID.

Background and Objectives: Individuals report persistent symptoms after becoming infected by SARS-CoV-2 (COVID-19) that last for >4 weeks (long-COVID syndrome). Dizziness and hearing loss have been reported among long-COVID symptoms. However, little is known about the potential predictors of dizziness and hearing loss in individuals with long COVID. This study aimed to explore the presence and correlates of dizziness and hearing loss in a sample of people with long-COVID syndrome. Materials and Methods: Individuals aged 18 years and older who were infected with COVID-19 at least 8 weeks prior to the start of the study were included if they were not diagnosed with dizziness or hearing loss before getting COVID-19. Demographics and COVID-19-related information were collected. Participants completed the Dizziness Handicap Inventory (DHI), Activities-Specific Balance Confidence (ABC) scale, Falls Efficacy Scale International (FES-I), Modified Fatigue Impact Scale (MFIS), and Medical Outcomes Study Short Form 12 (SF-12). Finally, hearing was assessed using pure-tone audiometry (PTA) in a subsample. Results: Two hundred and nine individuals (66% female) with a mean (SD) age of 27 (9) participated in the study. Perceived dizziness and hearing loss were reported in 26 and 15.3% of the sample, respectively. Logistic regression was conducted to identify potential predictors of dizziness and hearing loss separately. After controlling for age and severity of dizziness, female sex and high fatigue severity were associated with an increased likelihood of reporting dizziness (R2 = 31%). The severity of dizziness and neurological symptoms during the acute stage of COVID-19 were associated with an increased likelihood of reporting hearing loss (R2 = 10.4%) after controlling for age. Conclusions: Dizziness and hearing loss present in long COVID and can be disabling. Females with high levels of fatigue should be questioned about persistent dizziness. Hearing loss should be considered in individuals with neurological symptoms and severe dizziness as a consequence of long COVID.

Relationship between fear of falling and fall risk among older patients with stroke: a structural equation modeling

BackgroundWith reduced balance and mobility, older patients with stroke are more susceptible to fear of falling (FOF). A maladaptive form of FOF can cause excessive activity restriction, poor balance, and recurrent falls, forming a self-reinforcing vicious cycle. This study applied and adapted the FOF model to investigate the interaction between FOF and fall risk in older stroke patients.MethodsA cross-sectional study was conducted among 302 older stroke patients aged 60 and over. All participants were invited to complete the FOF, fall risk, physical activity, and balance tests, which were measured by the Falls Efficacy Scale International (FES-I), Self-Rated Fall Risk Questionnaire (FRQ), the long-form International Physical Activity Questionnaire (IPAQ-LF) and the Four-Stage Balance Test (FSBT) respectively. Data were analyzed using structural equation modeling.ResultsThe mean age of the respondents was 68.62 ± 7.62 years; 8.94% reported a high level of FOF, and 18.21% reported a moderate level of FOF. The structural equation model showed that FOF was directly associated with fall risk (β=-0.38, p < 0.001), and was indirectly associated with fall risk via physical activity (β=-0.075, p < 0.05) and balance ability (β=-0.123, p < 0.05). Depression (β=-0.47, p < 0.001), fall history (β=-0.13, p < 0.05), and female sex (β=-0.16, p < 0.05) affected FOF, while anxiety was not associated with FOF.ConclusionsThe increased risk of falling in older stroke patients results from a maladaptive FOF affected by depression, fall history, poor balance ability, and limited physical activity. Our results suggest that greater attention should be paid to FOF during stroke recovery and fall prevention. A multifaced intervention program encompassing physiological and psychological factors should be designed to address FOF and prevent falls.