![]() ![]() Balance Training: This can begin with the tasks or activities the individual finds stressful or anxiety-inducing.Muscle Strengthening: Elderly adults are at risk of reduced muscle bulk and function but this can be reversed to a degree so a progressive strengthening programme should be initiated.The following are techniques that should all be incorporated in therapy. A home-based multifactorial falls prevention program eg Otago balance program.What works (based on a 2007 systematic review): Management / Interventions Ī recent, Cochrane study of community-dwelling adults over 65 has shown that exercise reduces the rate of falls and the number of people experiencing falls in older people living in the community. Falls Efficacy Scale International (FES-I)).Ī 2021 Scoping Review on FOF found that " FES is likely more sensitive for detecting FOF than single questions, though further studies comparing the predictive validity of single questions to the FES and other FOF measurements are required". Scales examining perceived self-efficacy in one’s balance and/or ability to avoid falls (e.g.Fear of Falling Avoidance Behaviour Questionnaire) Scales examining FOF during specific activities (e.g.Asking a single question about FOF (e.g., “Do you have a fear of falling?”).Cognition - although this may fall outside of the physiotherapist's scope of practice.transfers on/off chair and bed, walking indoors, walking outdoors, mobilising on steps, mobilising to and from bathroom, what aids (if any) are used or have been tried in the past Previous treatment for anxiety in general and if/how FOF has been treated in the past.Medications the person in currently taking.Descriptions of activities that cause the person anxiety.Current mobility both in the home and in the community.History of falls including incident, any subsequent treatment and rehabilitation, life changes (or not) after fall/s.Recent pattern of activity - over days, months, year.ĭiagnostic Procedures Subjective Assessment "I am anxious at the thought of going outside and falling in the garden and breaking a bone so I am not going to do gardening anymore." The individual may present with depression and low mood and not being able to participate in their usual ADLs and social roles as a result of their FOF. nervous whilst walking outside down a steep path, versus anxiety which prevents activity e.g. Anxiety and Depression: In regards to anxiety, Harding et al distinguish between anxiety accompanying the activity e.g.Hence a FOF can become a "self-fulfilling prophecy" and a cycle of fear, reduced activity, reduced physical function, falls and injuries and so on. Reduced Mobility: The result of reduced ADLs leads to muscle weakness and loss of balance reactions which increases the person's actual chance of falling.A longer exposure to FOF has been linked with an increased risk of functional decline. As a result, they will reduce their usual activities which can show up in a subjective of the person's recent activities or ADLs compared to what they, or a carer, report they used to do. As a result, the person becomes fearful of moving in case they fall and hurt themselves. Functional Decline: The person may have had a fall or known someone who had a fall and sustained serious injuries.No close family or friends for emotional supportĬlinical Presentation įOF shows a clinical presentation with these features:. ![]() Believing they are unable to do normal activities (low falls self-efficacy). ![]() Reasons older people can may have a FOF include: Please see the Falls page for further detail.
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