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Background: Falls has been well established as one of the leading causes of mortality and morbidity among older adults.Falling in elderly persons can lead to disability, hospitalizations, and premature death. It can also lead to reduced levels of independence, poorer quality of life, and high levels of anxiety. It is proven that the elderly develop a fear of fall (FOF) due to the above mentioned consequences. They develop FOF with or without the history of fall. Increasing age is a significant predictor of FOF. FOF thus cause restriction in social participation and also restrictions in activities of daily living (ADL). Sitting on the floor is a tradition or a habit of Indians during activities like eating, praying, socializing etc., thus making it an important ADL. Thus, sitting and rising from the floor is a basic functional task for Indian population. The inability to sit and get up from the floor is closely related to the risk of falling, and if a fall has occurred, the capacity to return to an upright position is critical. Materials and Methods: The study included 210 community dwelling elderly population of an age group of 60-90 yrs, with an ability to sit on and get up from the floor. Individuals with any musculoskeletal, cardiorespiratory and neurological conditions were excluded. A physical assessment was done which included two tests. 1. Falls Efficacy Scale – International (in hindi) to assess fear of fall 2. Sitting Rising Test (SRT) to assess the ability to sit on and get up from the floor. A partial correlation analysis was conducted to find a relationship between Fear of Fall and the ability to sit on the floor after controlling for age. Alpha level is set as 0.05. Spearman’s rho test was used. Result: According to Spearman’s Rho’s Test of Correlation, Correlation between Fall Efficacy Scale – International & Sitting – Rising Test is -0.352. Thus showing that there is a Low Negative Correlation between the Fear of Fall and Ability to Sit on and Get up From the Floor. Conclusion: There is a relationship between Fear of Fall and the ability to sit on and get up from the floor in the elderly population.
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Objective To translate the Iconographical Falls Efficacy Scale (Icon-FES)and verify its reliability and validity in community-dwelling older people. Methods After obtaining authorization, the Icon-FES was initially developed according to the guidelines for cross-cultural adaptation. Adopting a convenient sampling method, from December 2017 to March 2018, 450 older adults from 2 communities in Wuhan City were selected to fillgeneral information questionnaire, iconographical falls efficacy scale(Icon-FES)and falls efficacy scale-international(FES-I). Results The Cronbach α coefficient of Icon-FES was 0.972( the shorten Icon-FES was 0.902);split-half reliability was 0.947; retest reliability coefficient was 0.951. Based on the rotation factor component matrix and scree plot, 2 common factors were selected and the cumulative variance contribution rate was 67.33％.The Spearman rank correlation coefficient between Icon-FES and FES-I was 0.663. Conclusion Icon-FES has good reliability and validity in measuring the fear of falls in the community, especially for the elderly with low cultural level and strong activity in China. The shorten Icon-FES is also one of the quick and simple tools.
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Objective To investigate the status and influencing factors of fear of falling (FOF) in patients with first ever cerebral infarction. Methods A sample of 105 inpatients with cerebral infarction were recruited from two tertiary hospitals in Tianjin (Tianjin Huanhu Hospital, the First Affiliated Hospital of Tianjin University of TCM) to complete this research. They were investigated with the simplified Chinese version of Falls Efficacy Scale International-short (FES-Is), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Barthel Index Rating Scale (BI) and Functional Ambulation Category Scale (FAC). Results The total score of FES-Is was 15.38±7.45. Multiple stepwise regression analysis showed that age, marital status, fall history, walking ability and anxiety were important factors of FOF. Conclusions Clinical staff should guide the patients with first cerebral infarction especially who had a history of falling to take active and effective measures to deal with their FOF, and pay more attention on patients who was elderly, without a spouse, assisted walking and anxiety, to release their FOF, prevent the falling and promote the functional recovery of patients.
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@#Objective To introduce the Chinese version of short Falls Efficacy Scale International (short FES-I) and test its reliability and validity in patients with cerebral infarction. Methods The English version and the traditional Chinese version of short FES-I were ob-tained from the Prevention of Falls Network Europe, and the simplified Chinese version was developed after a further revision. A sample of 105 inpatients with cerebral infarction from December 2014 to May 2015 were recruited from 2 tertiary hospitals in Tianjin. They were in-vestigated with the simplified Chinese version of short FES-I, modified Falls Efficacy Scale (MFES), Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). At the same time, the laboratory indexes of the patients were collected. Results The Cronbach'sαcoefficient of short FES-I was 0.98 and the score of short FES-I was negatively correlated with MFES (r=-0.41, P<0.001). Short FES-I was correlated wtih GAD-7 score (r=0.52, P<0.001), PHQ-9 score (r=0.46, P<0.001) and the level of C reaction protein (r=0.21, P=0.032), but uncorrelated with other laboratory indexes (P>0.05). There was significant difference in the score of short FES-I be-tween the patients with or without falling. Conclusion Short FES-I is valid and internal consistant, and can be used as an assessment tool to screen fear of falling among patients with cerebral infarction.
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Objective We tried to translate the English version of the Falls Efficacy Scale,Swedish version [FES (S)] into Chinese and test the reliability and validity of the Chinese version of FES (S) in patients after stroke.Methods Totally 145 patients after stroke were recruited and were investigated by the Chinese version of FES (S).The result underwent analysis of reliability and validity.Results The internal consistency coefficient of the Chinese version of FES (S) were 0.896.The Cronbach's α coefficient of two dimensions,which were Activity of Daily Living Ability and Instrumental Activity of Daily Living,were 0.863 and 0.872.The split half coefficient was 0.653,test-retest reliability was 0.743.The content validity index(CVI)was calculated according to related formulas,which was 0.896～1.000,the average CVI of all items was 0.925,CVI of each item was above 0.8.Factor analysis got two factors,which explained 40.852％ of the total variance.Except for item 5,other items showed factor loading ＞0.4 for its common factor.Conclusions The Chinese version of FES (S) has been proved to be reliable and valid.It can be used as a valid tool for assessing stroke patients with risk for falls and self-confidence.
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Aims: To evaluate the effectiveness of individualized progressive resistance strength training (PRT) program in improving the confidence level among the institutionalized elderly with balance impairment, in comparison with traditional balance exercise (TBE), and combination of both (COMBI). Place and Duration of Study: The study was conducted between June 2008 and December 2012 in the geriatric care homes, Mangalore, India. Methodology: The eligible subjects were assigned to 3 groups (TBE, PRT and COMBI) using block randomization technique and allocation concealment was done. PRT group received strength training for the key muscles (hip flexors, extensors and abductors, knee flexors and extensors, ankle dorsiflexors and plantar flexors) essential for maintenance of balance. TBE group received conventional balance training and the participants of the COMBI group received TBE and PRT interventions alternately. All the three groups received their respective interventions 4 times a week for 6 months. The data was collected at baseline, 3rd and 6th month and the analysis was performed using Statistical Package for Social Sciences (SPSS) version 15. Both per-protocol and intention to treat methods of analyses were used. Results: Mean age of the 54 elderly participants (18 in each group) was 75.17 years and the comparison of the baseline variables revealed homogeneity between the groups. Between the baseline and six months, all the three groups showed notable reduction in Falls Efficacy Scale (FES) scores. The change scores (pre-post intervention) of FES were notable for all the three groups, but the statistical test did not reveal any significant differences between the groups. Conclusion: Individualized structured PRT intervention targeting the key muscles of lower limbs for balance maintenance, for a period of 6 months, is comparable to TBE in improving the falls efficacy. This in turn reduces self-induced functional restrictions among the non-frail elderly people living in geriatric homes.