Award Date

5-1-2016

Degree Type

Dissertation

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

Advisor 1

Merrill Landers

First Committee Member

Merrill Landers

Second Committee Member

Kai-Yu Ho

Number of Pages

50

Abstract

Background: Evidence suggests that there are several fall predictors in the elderly population, including previous fall history and balance impairment. To date, however, the role of psychological factors has not yet been thoroughly vetted in conjunction with physical factors as predictors of future falls. Objective: The purpose of this study was to determine which measures, physical and psychological, are most predictive of falling in older adults. Design: This was a prospective cohort study. Methods: Sixty-four participants (mean age=72.2 years, SD=7.2; 40 women, 24 men) with and without pathology (25 healthy, 17 with Parkinson disease, 11 with cerebrovascular accident, 6 with diabetes, and 5 with a cardiovascular diagnosis) participated. Participants reported fall history and completed physical-based measures (ie, Berg Balance Scale, Dynamic Gait Index, self-selected gait speed, Timed “Up & Go” Test, Sensory Organization Test) and psychological-based measures (ie, Fear of Falling Avoidance Behavior Questionnaire, Falls Efficacy Scale, Activities-specific Balance Confidence Scale). Contact was made 1 year later to determine falls during the subsequent year (8 participants lost at follow-up). Results: Using multiple regression, fall history, pathology, and all measures were entered as predictor candidates. Three variables were included in the final model, explaining 49.2% of the variance: Activities-specific Balance Confidence Scale (38.7% of the variance), Fear of Falling Avoidance Behavior Questionnaire (5.6% additional variance), and Timed “Up & Go” Test (4.9% additional variance). Limitations: Falls were based on participant recall rather than a diary. Conclusions: Balance confidence was the best predictor of falling, followed by fear of falling avoidance behavior, and the Timed “Up & Go” Test. Fall history, presence of pathology, and physical tests did not predict falling. These findings suggest that participants may have had a better sense of their fall risk than with a test that provides a snapshot of their balance.

Keywords

Balance; Falls; Falls prevention; Fear-avoidance

Disciplines

Physical Therapy

File Format

pdf

File Size

1.063 Kb

Degree Grantor

University of Nevada, Las Vegas

Language

English


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