Effect of decision aid intervention on fear of falling in elderly patients after total hip arthroplasty / 中国实用护理杂志

Objective:To investigate the intervention effect of decision aid on the fear of falling in elderly patients after total hip arthroplasty.Methods:This study was a quasi experimental research. From June 2021 to November 2021, 84 patients after total hip arthroplasty who were admitted to the Department of Orthopedics of Zhengzhou Central Hospital Affiliated to Zhengzhou University were selected as the research objects. According to the order of admission, they were divided into the control group (42 cases, 2 cases fell off ) and the observation group (42 cases). The control group was given routine nursing care and guidance for fear of falling, while the observation group was given a decision-making aid intervention program on the basis of the control group. The time to first getting out of bed, the scores of Modified Falls Efficacy Scale (MFES), Generalized Anxiety Disorder (GAD-7) and Harris Hip Score (HHS) were compared between two groups.Results:The time to get out of bed for the first time in the observation group was (42.71 ± 6.41) h, lower than that in the control group (49.95 ± 5.73) h, and the difference was statistically significant ( t=5.38, P<0.05). Twelve weeks after discharge, the GAD-7 score in the observation group was (4.64 ± 1.43), which was lower than that of the control group (6.85 ± 1.83), and the difference was statistically significant ( t=6.10, P<0.05). The score of the MFES in the observation group was [8.50(8.00,10.00)], which was higher than that in the control group [7.50(7.00,8.00)], and the difference was statistically significant ( Z=-6.26, P<0.05). The hip joint function score of the observation group was (81.74 ± 4.24), which was higher than that of the control group (74.30 ± 4.51), and the difference was statistically significant ( t=7.69, P<0.05). Conclusions:Decision support can advance the time of downward movement of elderly patients after total hip arthroplasty, reduce their anxiety and fear of falling, and improve hip function.

Effect of early ambulation time in lower limbs muscle strength in patients with total knee arthroplasty / 中国实用护理杂志

Objective:To investigate the effect of early ambulation time on lower limbs muscle strength and fear of falling in patients with total knee arthroplasty, so as to provide basis for promoting the postoperative rehabilitation of patients undergoing total knee arthroplasty.Methods:A total of 210 patients after unilateral total knee replacement from July 2018 to December 2019 in the Second Affiliated Hospital of Soochow University were included and assigned to experimental group 1, experimental group 2 and experimental group 3 by random digits table method, each group contained 70 cases, and the patients began ambulation at 16, 20, 24 hours after knee replacement, respectively. The peak torque (PT) of knee joints flexors and extensor as well as hamstrings quadriceps ratio (H/Q) were compared among three groups at 1 week, 1 month and 3 months after knee replacement. The fall efficiency was evaluted by Modified Fall Efficacy Scale (MFES), the fear of falling rate was conducted by single item method.Results:After 1 month of knee replacement, the PT of knee joints flexor and extensor and H/Q were (18.73±5.49) N·m, (37.56±7.76) N·m, (48.08±9.19)% and (18.44±5.27) N·m, (37.04±7.07) N·m, (47.49±9.30)% in the experimental group 1 and experimental group 2, which were higher than those in the experimental group 3(16.38±2.85) N·m, (33.75±6.75) N·m, (43.48±7.17)%, the differences were statically significant ( t values were 2.316-3.057, P<0.05). After 1 week of knee replacement, the fear of falling rate were 72.3%(47/65) and MFES scores were (3.14±0.58) points in the experimental group 1, 53.7%(36/67), (3.81±0.65) points and 50.8%(32/63), (3.87±0.74) points in the experimental group 2 and experimental group 3, the fear of falling rate significantly increased and MFES scores significantly decreased in the experimental group 1 compared to the experimental group 2 and experimental group 3, the differences were statistically significant ( χ2 values were 5.780, 4.878, t values were 6.221, 6.129, P<0.05). Conclusions:Twenty hours after knee replacement is the best time for ambulation, which can shortern the time for lower limbs muscle strength recovery and reduce the risk of fear of falling.

Association between a hilly neighborhood environment and falls among rural older adults: a cross-sectional study / Journal of Rural Medicine

Objective: Falls in older adults are a major public health issue, and it is unclear whether the neighborhood environment is associated with falls among this group. This cross-sectional study investigated whether hilly neighborhood environmental factors were associated with fall status (falls or fear of falling) in rural Japanese older adults.Materials and Methods: Data obtained from 965 participants aged 65 years and older living in Unnan City, Shimane Prefecture, Japan, in 2017 were analyzed. Fall status was assessed based on the 1-year fall incidence (yes/no) for the past year and fear of falling (yes/no) using a self-report questionnaire. For hilly neighborhood environmental factors, the mean elevation and land slope were assessed using a geographic information system. The logistic regression model examined the odds ratios (OR) and 95% confidence intervals (CIs) of fall status in quartiles for elevation and land slope, respectively, and was adjusted for confounders.Results: Falls and fear of falling were observed in 16.8% and 43.2% of participants, respectively. Falls were associated with elevation (OR 1.99, 95% CI 1.17–3.37 for Q2 vs. Q1; OR 2.02, 95% CI 1.19–3.44 for Q3 vs. Q1) and land slope (OR 1.74, 95% CI 1.04–2.93 for Q3 vs. Q1; OR 1.74, 95% CI 1.04–2.93 for Q4 vs. Q1). Fear of falling was associated with elevation (OR 1.78, 95% CI 1.19–2.65 for Q3 vs. Q1) and land slope (OR 1.51, 95% CI 1.01–2.25 for Q4 vs. Q1).Conclusion: Our study found that elevation and land slope as hilly neighborhood environment factors were positively associated with falls or fear of falling among older adults living in rural Japan. Prospective observational studies that investigate the effects of region-specific environmental factors on falls among older adults should be conducted.

Effect of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention / 中国实用护理杂志

Objective@#To investigate the effectiveness of normal limbs active exercise rehabilitation training in fear of falling and motor function in patients with cerebral infarction after intervention.@*Methods@#A total of 74 cerebral infarction after intervention patients were enrolled in Wanbei Coal-Electricity Group General hospital from May 2016 to April 2018. Patients were randomly divided into the observation group 37 patients and the control group 37 patients according to the random number table method. The control group received routine rehabilitation training, normal limbs active exercise rehabilitation was carried out in the observation group. After 3 months of intervention, the fear of falling, activities of daily living, limbs motor function was assessed by short Falls Efficacy Scale International (FES-I), Barthel index, Fugl-Meyer motor function scoring, respectively.@*Results@#Before intervention, the short FES-I score was (15.32±3.15) and (15.47±4.89) in the observation group and in the control group respectively, after intervention, the score was (10.21±2.67) and (12.28±4.05), respectively. There was no significant difference in short FES-I scores between the two groups pre-intervention (P> 0.05). However, the short FES-I scores were significantly decreased in the observation group compared to the control group at post-intervention (t value was 2.468, P<0.05). Before intervention, the scores of Barthel index, upper limb motor function, lower limb motor function were (33.15±7.08), (22.88±4.42), (15.31±3.38) in the observation group, and (33.40±3.78), (22.26±5.03), (16.04±3.30) in the control group, however, those index mentioned above were (47.96±8.45). There was no significant difference in Barthel index, motor function scores between two groups pre-intervention (P>0.05). However, those scores were significantly increased in the observation group compared to the control group at post-intervention (t value was 2.562, 2.878, 4.553, P<0.05).@*Conclusion@#Normal limbs active exercise rehabilitation training can alleviate the fear of falling and promote motor function and self-care ability of patients with cerebral infarction after intervention.

Factors affecting fall fear in the first movement of elderly patients after total knee or hip arthroplasty / 中国组织工程研究

BACKGROUND: Hip and knee arthroplasty is currently the fundamental measure to improve the severe joint dysfunction and pain caused by elderly hip and knee joint diseases. However, the fear of falling seriously affects the time for elderly patients to go to the ground, and it is clear that the elderly patients with hip and knee arthroplasty are afraid of falling. The occurrence factors have important guiding significance for the early clinical intervention of such patients. OBJECTIVE: To explore the factors influencing the fear of falling during the first ambulation after total knee arthroplasty and total hip arthroplasty in elderly patients. METHODS: 242 elderly patients who underwent hip and knee arthroplasty in Wuming Hospital, Guangxi Medical University from January 2015 to January 2019 were selected as the study subjects, and the incidence of fall fear was observed. The risk factors of fall fear were analyzed by single factor and multi-factor Logistic analysis. RESULTS AND CONCLUSION: (1) The incidence of fall fear was 65.6%. (2) The univariate analysis showed that there was no significant difference in gender and education level between patients with and without fear of falling (P > 0.05). There were significant differences in age, type of replacement, past fall history, pain score, anxiety, depression, types of chronic diseases and visual impairment between patients with and without fall fear (P < 0.05). (3) The multivariate Logistic analysis showed that age (≥70 years old), visual analogue scale pain score of 7-10, anxiety and past fall history were risk factors for falling fear (P < 0.05). (4) It is suggested that elderly patients have a higher incidence of fear of falling when going to the ground for the first time after hip and knee arthroplasties. Post-operative pain, anxiety, age and history of falling are risk factors affecting fear of falling. Clinical attention should be paid to these risk factors in order to alleviate fear of falling and promote early recovery.

Cross-cultural adaptation of the Iconographical falls efficacy scale / 中国实用护理杂志

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.

Backward Gait is Associated with Motor Symptoms and Fear of Falling in Patients with De Novo Parkinson's Disease

BACKGROUND AND PURPOSE: Many previous studies have investigated forward gait (FG), backward gait (BG), and dual-task gait (DG) in patients with Parkinson's disease (PD). However, it remains uncertain whether gait parameters are implicated in motor symptoms or the risk of falling, especially in patients with de novo PD. METHODS: Demographic and clinical characteristics including the Fear of Falling Measure (FFM) were assessed in patients with de novo PD and in healthy subjects. A computerized gait analysis using the GAITRite system was performed for FG, BG, and DG. The Unified Parkinson's Disease Rating Scale Part III was assessed in patients with PD. RESULTS: This prospective study included 24 patients with de novo PD and 27 controls. Compared with controls, patients with de novo PD showed a slower gait and shorter stride in all three gaits. Patients with de novo PD also exhibited increases in the stride-to-stride variability in the stride time and stride length of the gait for BG, increased length for DG, and no increase for FG. Moreover, the BG speed in de novo PD patients was significantly associated with their motor symptoms (bradykinesia, postural instability, gait difficulty, and total motor score) and negatively correlated with the FFM score. CONCLUSIONS: The BG dynamics were more impaired and more closely related to motor symptoms and fear of falling than were the FG or DG dynamics in patients with de novo PD, indicating that BG parameters are potential biomarkers for the progression of PD.

Preditores do medo de cair em idosos portugueses na comunidade: um estudo exploratório / Predictors of the fear of falling among community-dwelling elderly Portuguese people: an exploratory study

Resumo O medo de cair é um fator de risco de queda. Também tem sido associado ao declínio funcional, diminuição da qualidade de vida e aumento do isolamento social na população idosa. Este estudo teve como objetivo analisar preditores do medo de cair em pessoas idosas portuguesas residentes na comunidade. Foi desenvolvido um estudo transversal com uma amostra de conveniência de 98 participantes (57,1% mulheres; média etária 74,07 ± 8,74 anos). O protocolo de coleta de dados incluiu um questionário sociodemográfico e de saúde, a Escala de Confiança no Equilíbrio específica para a Atividade, a Escala de Ansiedade e Depressão Hospitalar, a Escala Breve de Redes Sociais de Lubben, o Timed Up and Go, e o Teste de Sentar e Levantar Cinco Vezes. Os dados foram analisados com recurso à estatística descritiva e inferencial. Os resultados indicam que no gênero feminino (p = 0.01), a percepção de saúde física boa (p = 0.01) e moderada (p = 0.02) e os sintomas de depressão (p ≈ 0.00) são preditores do medo de cair. Controlar estes preditores é um aspecto fundamental para a promoção da independência das pessoas idosas, minimizando as consequências associadas ao medo de cair.

Abstract The fear of falling constitutes a real risk factor for falls. It has also been associated with functional decline, decreased quality of life and increased social isolation among the elderly population. This study analyzed predictors of the fear of falling in elderly Portuguese people that live in the community. A cross-sectional study with a convenience sample of 98 participants (57.1% women; mean age 74.07 ± 8.74 years) was conducted. Data were collected with a protocol which includes a questionnaire for sociodemographic and health information, the Activity Specific Balance Confidence Scale, the Hospital Anxiety and Depression Scale, the Lubben Social Network Scale-6, the Timed Up and Go, and Five Times Sit to Stand Test. Data were analyzed using descriptive and inferential statistics. The results showed that female gender (p = 0.01), the perception of good (p = 0.01) and moderate (p = 0.02) physical health and the symptoms of depression (p ≈ 0.00) are predictors of fear of falling. Controlling these predictors is a fundamental aspect for promoting the independence of elderly people minimizing the consequences that are associated with the fear of falling.

Perfil de saúde de idosos adventistas que ultrapassaram a expectativa de vida / Health profile of adventist elders who exceeded life expectancy / Perfil de salud de ancianos adventistas que superaron la expectativa de vida

O objetivo deste estudo foi verificar aspectos do perfil de saúde de idosos adventistas do sétimo dia que ultrapassaram a expectativa média de vida. O estudo realizado foi analítico observacional transversal. Participaram da pesquisa 90 idosos com média de idade de 82,9 anos. A coleta de dados consistiu na aplicação dos seguintes instrumentos de avaliação: o mini-exame do estado mental (MEEM), questionário sócio-demográfico para conhecer o perfil social; mini-avaliação nutricional (MAN), e a Escala Internacional de Eficácia de Quedas (FES). As atividades básicas da vida diária (AVDB) foram avaliadas pela escala funcional de Katz e a Escala de Lawton e Brody de atividades instrumentais de vida diária (AIVD). A maioria dos idosos entrevistados era de brancos, casados, com 7,3 anos de estudos, aposentados, filhos de pais longevos e do sexo masculino. A doença mais prevalente foi a hipertensão arterial. A carga de doenças foi de 3,2 doenças. A pontuação na Escala de Katz foi de 6,3±0,8 pontos, na Escala de Lawton e Brody de 25,1±3,8, na Escala FES foi de 24,7±10,4 e na MAN de 11,7±1,3 pontos. Não houve diferença ao serem comparados homens em relação a mulheres. Ao serem feitas as correlações entre as variáveis estudadas, houve muitas correlações significantes, porém fracas. Apenas 4 correlações foram consideradas moderadas. Correlação positiva entre AIVD e MEEM, entre AIVD e MAN, Correlação inversa entre AIVD e FES e AIVD e ABVD.

The objective of this study was to study the health profile of Seventh-day Adventist elderly who exceeded the average life expectancy. The study was transversal observational analytical. A total of 90 elderly people with an average age of 82.9 years participated in the study. The data collection consisted of the application of the following evaluation instruments: The mini mental state examination (MEEM), socio-demographic questionnaire to know the social profile; mini nutritional assessment (MAN), International Falls Efficiency Scale (FES). The basic activities of daily living (BADL) were assessed by the Katz functional scale and the Lawton and Brody Scale of instrumental activities of daily living (IADL). The majority of the elderly interviewed were white, married, with 7.3 years of education, retired, children of long-lived and male parents. The most prevalent disease was hypertension. The burden of disease was 3.2 diseases. The Katz Scale score was 6.3 ± 0.8 points, in the Lawton and Brody Scale of 25.1 ± 3.8, in the FES Scale was 24.7 ± 10.4 and in the MAN score of 11, 7 ± 1.3 points. There was no difference when men from women were compared. When the correlations between the studied variables were made, there were many significant but weak correlations. Only 4 correlations were considered moderate. Positive correlation between IADL and MEEM, between IADL and MAN, inverse correlation between IADL and FES and IADL and BADL.

El objetivo de este estudio fue aspectos del perfil de salud de los ancianos adventistas del séptimo día que sobrepasaron la expectativa media de vida. El estudio realizado fue analítico observacional transversal. Participaron de la encuesta 90 ancianos con promedio de edad de 82,9 años. La recolección de datos consistió en la aplicación de los siguientes instrumentos de evaluación: El mini examen del estado mental (MEEM), cuestionario socio demográfico para conocer el perfil social; minima evaluación nutricional (MAN), Escala Internacional de Eficacia de Caídas (FES). Las actividades básicas de la vida diaria (AVDB) fueron evaluadas por la escala funcional de Katz y la Escala de Lawton y Brody de actividades instrumentales de vida diaria (AIVD). La mayoría de los ancianos entrevistados eran blancos, casados, con 7,3 años de estudios, jubilados, hijos de padres longevos y del sexo masculino. La enfermedad más prevalente fue la hipertensión arterial. La carga de las enfermedades fue de 3,2 enfermedades. La puntuación en la escala de Katz fue de 6,3 ± 0,8 puntos, en la escala de Lawton y Brody de 25,1 ± 3,8, en la escala FES fue de 24,7 ± 10,4 y en la MAN de 11, 7 ± 1,3 puntos. No hubo diferencia al ser comparados hombres de mujeres. Al hacer las correlaciones entre las variables estudiadas, hubo muchas correlaciones significantes, pero débiles. Sólo 4 correlaciones se consideraron moderadas. Correlación positiva entre AIVD y MEEM, entre AIVD y MAN, Correlación inversa entre AIVD y FES y AIVD y ABVD.

Risk Factors Associated with the Fear of Falling in Community-Living Elderly People in Korea: Role of Psychological Factors

Little is known about the risk factors for the fear of falling in elderly Korean individuals. Thus, the present study aimed to investigate the risk factors for fear of falling in a representative elderly population of over 10,000 individuals aged 65 years and older. A multivariate multinomial analysis revealed that the risk factors associated with a severe fear of falling were being female [odds ratio (OR)=4.396], older age (OR=5.550 for those aged ≥85 years), lower level of education (OR=0.719 for those with ≥13 years of schooling), chronic illness (OR=2.788 for those with more than three chronic illnesses), poor subjective health (OR=6.268), functional impairments (OR=2.340), a history of falling (OR=7.062), and depression (OR=1.774). The ORs for each of these risk factors were particularly high in participants with a severe fear of falling. Particularly, a history of falling and/or poor subjective health status had strong independent associations with the fear of falling. The present findings may help health care professionals identify individuals that would benefit from interventions aimed at reducing the fear of falling.

Influence of flow Yoga on balance ability and fear of falling of community patients with stroke / 中国实用护理杂志

Objective To explore the effect of flow yoga on balance ability and fear of falling of community patients with stroke.Methods Divided 92 community patients with stroke into the intervention group (46 cases) and the control group (46 cases) randomly,routine community nursing cares were used in the control group,while the flow yoga were used in the intervention group in addition.The berg balance scale,single direct question of fear of falling and modified falls efficacy scale were used to evaluate balance ability and fear of falling after the intervention between the two groups.Results The patients' balance ability was (48.28±10.64) in the intervention group,which was significant higher than that of in the control group (32.04±11.42),t=6.316,P＜0.05.The fall efficacy in the intervention group was (132.03±27.38),which was significant higher than that of in the control group (108.74±25.68),t=8.256,P＜0.05.The rate of fear falling in the intervention group was 26.09％(12/46),which was significant lower than that of in the control group (32.16T％,15/46),x2=6.545,P＜0.05.Conclusion Flow yoga can improve stroke patients' balance ability and reduce fear of falling.

Reliability and Validity of Chinese Version of Short Falls Efficacy Scale International in Patients with Cerebral Infarction / 中国康复理论与实践

@#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.

The current status and influencing factors of falls self-efficacy among the stroke elderly patients / 中国实用护理杂志

Objective To investigate the current status and influencing factors of falls self-efficacy among the stroke elderly patients.Methods Totally 170 elderly stroke patients were investigated using the Modified Falls Efficacy Scale (MFES),and they were tested with Berg Balance Scale (BBS) and Time Up and Go Test (TUGT).Results The average score of falls self-efficacy was 108.There were 50.6％ elderly stroke patients assigned to the group with low falls self-efficacy.Multiple Logistic regression analysis indicated that impairments of balance and mobility,severe stroke-related disability were the independent influencing factors associated with FOF,which could explain 52.0％ of variations.Conclusions Low falls self-efficacy among the stroke elderly patients is a common complaint,nurses and physicians should focus on this problem,interventions combining exercise and education of accidental falls should be taken to improve falls self-efficacy of elderly stroke patients,and prevent falls finally.

Medo de cair e autopercepção de saúde em indivíduos idosos participantes e não participantes em programas de atividade física / El miedo de caer y la autopercepción de la salud en las personas mayores que participan y que no participan en programas de actividad física / Fear of falling and self-perception of health in older participants and non-participants of physical activity programs

Fear of falling, self-perception of health, and participation in physical activity programs have been associated with several variables related to health and performance in older adults. The purpose of this study was to evaluate self-perception of health and fear of falling in older adult participants and non-participants of physical activity programs, and to verify the relationship between these variables. A total of 40 healthy but sedentary older adults, and 45 physically active older adults were assessed through the Falls Efficacy Scale International-Brazil (FES-I) and a questionnaire that measured their self-perception of health. The older adults that did not participate in regular physical activity programs presented higher scores of fear of falling, which, in turn, is associated with an increase of risk for falls. Moreover, older adults, participants in regular physical activity programs exhibited a more positive health perception than did the non-participants. Also, non-participants of physical activity programs perceived their health status as being poor or very poor as well as expressing great concern about falling compared to those who considered their health as excellent, good or regular. The results of this study have important implications for making clinical decisions in prevention or rehabilitation of older people, and they justify recommendations to the public health system.

Medo de cair, autopercepção da saúde e participação em programas de atividade física têm sido associados a diversas variáveis relacionadas à saúde e ao desempenho de indivíduos idosos. O objetivo deste trabalho foi avaliar a autopercepção da saúde e o medo de cair em indivíduos idosos participantes e não participantes de programas de atividade física, e verificar a associação entre estas variáveis. Foram avaliados indivíduos idosos saudáveis, sendo 40 sedentários e 45 participantes de programas de atividade física regular, por meio da Falls Efficacy Scale International-Brasil (FES-I) e do questionário de autopercepção subjetiva da saúde.Indivíduos idosos não participantes de programas de atividade física regular apresentaram maior pontuação na avaliação do medo de cair, o que pode estar associado a um maior risco de quedas. Os indivíduos que participavam de programas de atividade física regular demonstraram melhor percepção da saúde do que os não participantes. Além disso, os indivíduos não participantes de programas de atividade física regular percebiam sua saúde como ruim ou péssima e apresentavam maior preocupação em cair, quando comparados com aqueles que consideravam sua saúde como ótima, boa ou regular. Estes Os resultados deste estudo têm implicações relevantes para a tomada de decisões clínicas na prevenção ou reabilitação de pessoas idosas, e justificam recomendações ao sistema de saúde pública.

El miedo de caer, la percepción de salud y la participación en programas de actividad física se han asociado con diversas variables relacionadas con la salud y el rendimiento de las personas de edad avanzada. El objetivo de este estudio fue evaluar la percepción de la salud y el miedo de caer en los participantes mayores y los no participantes en programas de actividad física, y la asociación entre estas variables. Se evaluaron 40 adultos mayores sanos, pero sedentarios y 45 fisicamente activos, a través de la Falls Efficacy Scale International-Brasil (FES-I) y de lo cuestionario de percepción subjetiva de la salud. Tercera edad que no participan en los programas regulares de actividad física mostraron una mayor preocupación por la caída, lo que indica un mayor miedo a caer, y que se asocia con un mayor riesgo de caídas. Por otra parte, las personas mayores participantes en el programa de actividad física regular tienen una mejor percepción de salud que los no participantes. Además, los no participantes en el programa de actividad física regular percibían su salud como mala o muy mala y tenían una mayor preocupación por la caída que los que calificaron su salud como excelente, bueno o regular. Los resultados de este estudio tienen implicaciones importantes para la toma de decisiones clinicas en la prevención y rehabilitación de las personas mayores, y justifican las recomendaciones para el sistema de salud pública.

Medo de cair e qualidade de vida em idosos com catarata / Fear of falling and quality of life in elderly with cataract

INTRODUÇÃO: O medo de cair é definido como baixa autoeficácia ou confiança no próprio equilíbrio para evitar quedas, causando declínio no desempenho físico e funcional, alterações no equilíbrio e na marcha dos idosos, tendo impacto negativo na qualidade de vida. Vários estudos têm identificado o déficit visual como fator contributivo para a ocorrência de quedas e do medo de cair em idosos. OBJETIVOS: Avaliar a associação entre o medo de cair e as alterações na visão funcional e na qualidade de vida relacionada à visão de idosos com catarata. MÉTODOS: Trata-se de estudo observacional com 139 idosos com catarata (71,4±6,2 anos). A qualidade de vida relacionada à visão foi avaliada pelo Visual Function Questionnaire (VFQ) e a preocupação com a possibilidade de quedas foi avaliada pela Falls Efficacy Scale International (FES-I-Brasil). RESULTADOS: Idosos que relataram algum grau de medo de cair apresentaram médias mais altas na escala FES-I-Brasil, quando comparados aos que não o relataram, indicando maior preocupação com a possibilidade de cair (p=0,000; Kruskal-Wallis). Com relação à visão funcional (VFQ) e à qualidade de vida relacionada à visão, quanto maior o medo de cair, piores eram a visão e a qualidade de vida (p=0,003; Kruskal-Wallis). CONCLUSÃO: Idosos com catarata e com relato de medo de cair apresentaram menor confiança no seu equilíbrio para evitar quedas e pior qualidade na visão funcional e na qualidade de vida relacionada à visão.

INTRODUCTION: Fear of falling is defined as low self-efficacy or self-confidence in one's own balance to avoid falls. It causes limitations in physical and functional performance, balance and walking impairment, and has negative impact on quality of life. Many research works have identified visual impairment as one of the factors that contribute to falls and fear of falling. OBJECTIVES: Evaluate the association between fear of falling and visual function impairment and the related-vision quality of life in elderly patients with cataract. METHODS: Observational study conducted with 139 elderly patients with cataract (71.4±6.2 years). Vision-related quality of life was assessed through the Visual Function Questionnaire (VFQ). Interviews were made by means of the Falls Efficacy Scale International (FES-I Brazil) to evaluate the concern with falling. RESULTS: Elderly patient with fear of falling had higher averages in FES-I-Brazil than other elderly patients (p=0.000; Kruskal-Wallis). The greater the fear of falling, the worst were the visual function (VFQ) and the related-vision quality of life (p=0,003; Kruskal-Wallis). CONCLUSION: Elderly patients with cataract and fear of falling had less self-confidence in their balance to avoid falls and worst functional vision and related-vision quality of life.

Medo de cair e sua relação com a medida da independência funcional e a qualidade de vida em indivíduos após Acidente Vascular Encefálico / Fear of falling and the relationship with the measure of functional independence and quality of life in post-Cerebral Vascular Accident (Stroke) victims

O objetivo deste estudo transversal foi avaliar o medo de cair em 52 indivíduos na fase crônica após Acidente Vascular Encefálico (AVE) e verificar sua relação com medidas de independência funcional e de qualidade de vida (QV). O medo de cair foi verificado através da versão brasileira da Falls Efficacy Scale International (FES-I-BRASIL), independência funcional através da Medida da Independência Funcional (MIF) e QV através da Escala de QV Específica para AVE (EQVE-AVE). Coeficientes de correlação de Spearman foram calculados para verificar associações entre a FES-I-BRASIL e os demais instrumentos, e o teste U de Mann-Whitney para comparar grupos com baixa e alta preocupação em cair. Houve predomínio de indivíduos com alta preocupação em cair, maior QV e independentes. A FES-I-BRASIL foi estatisticamente associada à MIF e à EQVE-AVE, sendo o mesmo observado nas subescalas transferências e locomoção da MIF e nos domínios energia, papéis familiares, linguagem, mobilidade, humor, autocuidado e função do membro superior da EQVE-AVE. Assim, o medo de cair pode contribuir para a redução da independência funcional e da QV de indivíduos pós-AVE, devendo ser inserido na avaliação desses pacientes, para que maiores benefícios possam ser garantidos na reabilitação.

The aim of this cross-sectional study was to evaluate the fear of falling of 52 chronic post-stroke individuals and to assess its relationship with measures of functional independence and quality of life (QOL). Fear of falling was assessed by the Brazilian version of Falls Efficacy Scale International (FES-I-BRAZIL) and functional independence by the Functional Independence Measure (FIM) and QOL by the Stroke Specific Quality of Life (SSQOL) scale. Spearman's correlation coefficients were calculated to verify the associations between FES-I-BRAZIL and the other instruments, and the Mann-Whitney U test to compare groups with low and high fall concerns. There was a predominance of individuals with high concerns regarding falling, higher QOL, and independents. FES-I-BRAZIL was statistically associated with FIM and SSQOL. Significant relationships were also found between FES-I-Brazil with FIM transfer and locomotion sub-scales, as well as with the following SSQOL energy, family role, language, mobility, mood, self-care, and upper extremity function domains. Thus, fear of falling may contribute to reduced functional independence and QOL in post-stroke individuals and should be included in the evaluation process of these patients to ensure greater benefits during rehabilitation.

The Association between Levels of Muscle Strength and Fear of Falling in Korean Olders / 대한스포츠의학회지

This study aims to investigate the association between muscle strength and fear of falling in Korean elderly. The study used data obtained by interview and physical test, targeting a total of 339 people 65 years old and over. In order to analyze the relationship between muscle strength and fear of falling we performed a logistic regression analysis to calculate odds ratio and 95% confidence interval after adjustments body mass index, smoking status, drinking status, cohabitation status, self-rated health, self-rated sight, cardiovascular disease and cancer status, history of falls. The levels of statistically significance were set at p<0.05. Through the logistic regression analysis, we found that the male elders who has high level of upper extremity strength and lower extremity strength appeared to have a significantly lower fear of falling than those who didn't. In addition, the female who has high level of lower extremity strength appeared to have a significantly lower fear of falling than those who didn't. This research results show a correlation between level of strength and fear of falling.

Temor a caer en ancianos: controversias en torno a un concepto y a su medición / Temor a cair e anciãos: controversias em torno a um conceito e a sua medição / Fear of falling in the elderly: controversy around a concept and its assessment

Introducción: La definición de temor a caer y los instrumentos para evaluarlo son claves para determinar la magnitud del problema y establecer estrategias de intervención adecuadas. El objetivo es hacer un análisis crítico de las definiciones y constructos de temor a caer y de los instrumentos de evaluación. Métodos: Se encontraron cerca de 1200 publicaciones entre 1980 y 2011, en diversas bases de datos y bibliotecas. Los criterios de exclusión fueron: idioma diferente al inglés, francés, portugués y español; incluir población menor de 60 años, no tener como objeto central el temor a caer y estar duplicados. Basados en estos criterios se retuvieron 337 documentos para la presente revisión. Resultados: Se han utilizado diferentes conceptos y términos para definir y evaluar el temor a caer. Las más comunes son: disminución de la autoeficacia, confianza en el equilibrio, preocupación, inquietud o ansiedad ante las caídas, miedo a caer, control percibido sobre las caídas y síndrome del temor a caer. Existen más de doce instrumentos de evaluación del temor a caer, desde una pregunta simple, hasta instrumentos elaborados para medir los diferentes constructos. Discusión / Conclusiones: El temor a caer se refiere a la eventualidad de un evento futuro, la confianza en el equilibrio y la autoeficacia se refieren a percepciones relacionadas con las capacidades actuales de la persona, es decir, son tres constructos diferentes. Se necesita mayor investigación en torno a la conceptualización del temor a caer. La claridad y precisión pueden ser útiles en el desarrollo de estrategias ajustadas a las necesidades individuales y de grupos

Introduction: The definition of fear of falling and the instruments to assess it are key to determine the scale of the problem and establish appropriate intervention strategies. The aim of this paper is to provide a critical analysis of definitions and constructs of fear of falling and assessment tools. Methods: Around 1,200 publications issued between 1980 and 2011 were found in diverse data bases and libraries. The exclusion criteria were: language different from English, French, Portuguese and Spanish; including population younger than 60 years old; not having as a central aim fear of falling and being duplicated. Based on these criteria, 337 documents were retained for this literature review. Results: Different concepts and terms have been used to define and assess fear of falling. The most common are decrease in self-efficacy, trust in equilibrium, worry, concern or anxiety about falls, fear of falling, control perceived about falling and fear of falling syndrome. There are more than twelve fear of falling assessment instruments, from the simple question to elaborated instruments to assess the different constructs. Discussion / Conclusions: Fear of falling refers to the possibility of a future event; trust in equilibrium and selfefficacy refer to perceptions related with the real capacities of the person, this is to say they are three different constructs.. Further research is needed regarding the conceptualization of fear of falling. The conceptual clarity and precision can be useful in developing strategies tailored to the individual and group needs

Introdução: A definição de temor a cair e os instrumentos para avaliar ló são chaves para determinar a magnitude do problema e estabelecer estratégias de intervenção adequadas. O objetivo é fazer um analise critico das definições e constructos de temor a cair e dos instrumentos de avaliação. Métodos: encontraram se perto de 1200 publicações entre 1980 e 2011, em diversas bases de dados e bibliotecas. Os critérios de exclusão foram: idioma diferente ao inglês, francês, português e espanhol; incluir povoação menor de 60 anos, não ter como objeto central o temor a cair e estar duplicados. Baseados nestes critérios se retiveram 337 documentos para a presente revisão. Resultados: Tem se utilizado diferentes conceitos e términos para definir e avaliar o temor a cair. As mais comuns são: diminuição da autoeficácia, confiança no equilíbrio, preocupação, inquietude ou ansiedade ante as caídas, medo a cair, controle percebido sobre as caídas e síndrome de temor a cair. Existem mais de doze instrumentos de avaliação do temor a cair, desde uma pergunta simples, até instrumentos elaborados para medir os diferentes constructos. Discussão / Conclusões: O temor a cair se refere à eventualidade de um evento futuro, a confiança no equilíbrio e auto eficácia se referem a percepções relacionadas com as capacidades atuais da pessoa, é dizer, são três construtos diferentes. Precisa se maior pesquisa em torno à conceituação do temor a cair. A claridade e precisão podem ser uteis no desenvolvimento de estratégias ajustadas às necessidades individuais e de grupos

Avaliação de um grupo de idosos no bairro do Butantã (SP) no suposto medo de queda / Evaluation of a group of Elderly in the neighborhood Butantã (SP) in the supposed fear of falling

O processo de envelhecimento vem acompanhado por problemas de saúde físicos e mentais, provocados, via de regra, por doenças crônicas e quedas. Objetiva-se identificar o suposto medo de cair, ao realizar atividades da vida diária, em um grupo de idosos. A abordagem foi descritiva, por meio de um estudo transversal, com a utilização da versão brasileira do questionário traduzido por Camargos (2007). Foram entrevistados 20 idosos com 60 anos ou mais, moradores do bairro de Butantã, na cidade de São Paulo (SP). Como resultados, pôde-se verificar que, por mostrarem receio de cair, a maioria dos idosos evitam realizar certas atividades de sua vida diária (AVD), dentre outras decorrências...

The aging process is accompanied by problems of physical and mental health caused often by chronic diseases and falls. Objectives: To identify the alleged fear of falling while performing activities of daily living in an elderly group. Material and Methods: A descriptive approach, a cross-sectional study using the Brazilian version of the questionnaire translated by Camargo (2007). Will be interviewed 20 elderly aged 60 or older, residents of the neighborhood Butantã (SP) randomly. Results: For fear of falling show most seniors avoid in performing certain activities...

Medo de quedas em idosos do Núcleo da Unidade Básica de Saúde João da Silva Vizella / Fear of Falls in Elderly of the Center of Basic Unit João da Silva Vizella

O envelhecimento da população brasileira, recebeu influências do fenômeno da transição demográfica e a partir dos dados censitários disponíveis já encontramos números semelhantes ao de países desenvolvidos. Com isto aumentaram as preocupações com as comorbidades. As quedas dos idosos são consideradas como um dos grandes problemas dos que envelhecem e investigar as quedas dos idosos foi a proposta deste estudo que investigou os idosos que frequentavam as oficinas propostas no projeto Vida Saudável que ocorreram na Unidade Básica de Saúde João da Silva Vizella. A literatura indica como preditor de queda o medo que as mesmas causam, que tanto pode ocorrer pós uma queda, como também sem a pessoa reconhecer a existência de uma queda importante na sua vida. O objetivo geral do estudo foi o de estudar a relação medo e quedas. Utilizou-se como metodologia a aplicação de uma escala denominada FES-I Brasil que investiga a autoeficácia em executar determinadas tarefas, e de uma análise de conteúdo das entrevistas realizadas com as 15 participantes que se dispuseram a participar do estudo. No capítulo 1 discutimos a fundamentação que deu suporte a investigação, na sequência, no capítulo 2, apresentamos as opções metodológicas, descrevemos a forma como se estruturou a pesquisa e a coleta dos dados. No capítulo 3 apresentamos a análise dos dados coletados: encontramos uma medida central através da mediana, sem no entanto, sermos capazes de dizer se quem cai mais é quem tem mais medo; dito de outra forma, quem têm menor autoeficácia. No grupo investigado todos apresentaram quedas importantes e o medo das quedas em maior ou menor grau esteve presente no discurso das entrevistadas. A partir da análise do conteúdo das entrevistas pode-se conhecer melhor sobre as quedas do grupo. Categorias serviram para dialogar com as entrevistas e uma delas não prevista, veio a ser a da "fé como justificativa", procurou minimizar o problema, desta forma, controlando a emoção expressa pelo sentir medo que acompanhou o grupo investigado. Apresentamos nas nossas considerações finais a relação das quedas que acontecem com os idosos e o sentimento de medo que as mesmas provocam entre as participantes da UBS-Vizella

The aging population, has been influenced by the phenomenon of demographic transition and from the census data available since we found similar numbers to that of developed countries. With this raised concerns with comorbidities. Falls in elderly are regarded as one of the major problems of aging and to investigate the falls of the elderly was the purpose of this study investigating the elderly who attended the workshops proposed in the Vida Saudável Project which occurred in the Basic Health João da Silva Vizella. The literature indicates the decline as a predictor of fear that they cause, which may occur either after a fall, but no one recognized the existence of a significant drop in his life. The overall objective of the study was to study the relationship fear and falls. Was used as a methodology to apply a scale called FES-I Brazil that investigates the self-efficacy in performing certain tasks, and a content analysis of interviews with 15 participants who were willing to participate. In chapter 1 we discussed the rationale that has supported the research, following, in Chapter 2, we present the methodological options, we describe the way they structured the research and data collection. In chapter 3 we present the analysis of data collected: find a measure through the center median, without however being able to say whether those who fall is over who has more fear, in other words, who have lower self-efficacy. In the group investigated all showed significant falls and fear of falls in greater or lesser degree was present in the discourse of the interviewees. From the analysis of the interviews one can know better about the falls of the group. Categories used to dialogue with the interviews and one not envisaged, became the "faith as a justification," sought to minimize the problem, thereby controlling the emotion expressed by the fear that accompanied the group investigated. We present our final considerations in the relationship of falls that occur with the elderly and the feeling of fear that they cause among the participants of the UBS-Vizella