Poststroke fear of falling in the hospital setting

Abstract

Purpose: Fear of falling (FoF) has a negative impact on older adults, however there is a paucity of research regarding the development and impact of FoF after stroke. Therefore, our objectives were to determine the proportion of individuals with FoF and the affect of FoF during the immediate poststroke period.

Methods: This observational study of baseline data from a pilot cohort study includes a convenience sample of 28 adults with acute stroke before discharge home. Measures include self-reported FoF, the Falls Efficacy Scale-Swedish Version [FES(S)], Stroke-Specific Quality of Life (SS-QOL), performance and satisfaction with performance (Canadian Occupational Performance Measure), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9).

Results: Fifteen (54%) of the participants reported FoF. Those with FoF were more likely to have decreased SS-QOL domain scores for energy (p = .013), personality (p = .015), and thinking (p = .008); decreased performance (self-care, productivity, and leisure) (p = .019) and satisfaction with performance (p = .010); and increased anxiety (p = .002) than those without FoF.

Conclusions: Those with FoF demonstrated significantly increased anxiety and showed decreased performance and satisfaction with performance, energy, thinking, and personality than those without FoF. This suggests that poststroke FoF is related not only to physical challenges but also to cognitive and emotional factors in the poststroke period. Identifying and treating these conditions should be evaluated as a means to decrease FoF and improve outcomes post stroke.