"A Theoretical Framework for Addressing Fear of Falling Avoidance Behav" by Merrill R. Landers and Maria H. Nilsson
 

Document Type

Article

Publication Date

2-18-2022

Publication Title

Physiotherapy Theory and Practice

Volume

39

Issue

5

First page number:

895

Last page number:

911

Abstract

Postural instability in Parkinson’s disease (PD) is associated with several downstream consequences that ultimately lead to a greater risk of falling. Among the prominent downstream consequences is fear of falling (FOF), which is both common and problematic in PD. It can lead to a vicious cycle of FOF avoidance behavior that results in more sedentary behavior, physical deconditioning, and weakening of already impaired balance systems. This, in turn, may make the person with PD more susceptible to a future fall even with benign daily tasks. While FOF activity avoidance can be adaptive (appropriate), it can also be maladaptive (inappropriate or exaggerated). When this adaptive and maladaptive FOF avoidance behavior is contextualized to gait/balance performance, it provides a theoretical framework that can be used by clinicians to match patterns of behavior to a concordant treatment approach. In the theoretical framework proposed in this perspective, four different patterns related to FOF avoidance behavior and gait/balance performance are suggested: appropriate avoiders, appropriate non-avoiders, inappropriate avoiders, and inappropriate non- avoiders. For each of the four FOF avoidance behavior patterns, this paper also provides suggested treatment focuses, approaches and recommendations.

Keywords

Parkinson’s disease; falls; neurorehabilitation; balance; gait; physiotherapy

Disciplines

Movement and Mind-Body Therapies | Physiotherapy

File Format

PDF

File Size

3700 KB

Language

English

Rights

IN COPYRIGHT. For more information about this rights statement, please visit http://rightsstatements.org/vocab/InC/1.0/

Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.

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