Fear of Falling: Difference between revisions
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== Definition == | == Definition == | ||
A fear of falling (FOF) or post-fall syndrome is a person's anxiety towards walking or mobilising, with the perception that a fall will occur. It is common after a fall although it can occur in the absence of a fall Vellas et al. | A fear of falling (FOF) or post-fall syndrome is a person's anxiety towards usual or normal walking or mobilising, with the perception that a fall will occur. It is common after a fall although it can occur in the absence of a fall Vellas et al. | ||
Falls are a significant cause of morbidity and mortality. Please see the Falls page for further detail. | |||
== Clinical Presentation == | == Clinical Presentation == | ||
=== Functional Decline === | |||
The person may have had a fall or known someone who had a fall and sustained serious injuries. As a result, the person becomes fearful of moving in case they fall and hurt themselves. As a result, they will reduce their usual activities which can show up in a subjective of the person's recent activities or ADLs compared to what they, or a carer, report they used to do. | The person may have had a fall or known someone who had a fall and sustained serious injuries. As a result, the person becomes fearful of moving in case they fall and hurt themselves. As a result, they will reduce their usual activities which can show up in a subjective of the person's recent activities or ADLs compared to what they, or a carer, report they used to do. | ||
=== Reduced Mobility === | |||
The result of reduced ADLs leads to muscle weakness and loss of balance reactions which increases the person's actual chance of falling. Hence a FOF can become a "self-fulfilling prophecy" and a cycle of fear, reduced activity, reduced physical function, falls and injuries and so on. | The result of reduced ADLs leads to muscle weakness and loss of balance reactions which increases the person's actual chance of falling. Hence a FOF can become a "self-fulfilling prophecy" and a cycle of fear, reduced activity, reduced physical function, falls and injuries and so on. | ||
In regards to anxiety, Harding et al distinguish between anxiety accompanying the activity e.g. nervous whilst walking outside down a steep path, versus anxiety which prevents activity e.g. "I am anxious at the thought of going outside and falling in the garden and breaking a bone so I am not going to do gardening anymore."<br> | === Anxiety and Depression === | ||
In regards to anxiety, Harding et al distinguish between anxiety accompanying the activity e.g. nervous whilst walking outside down a steep path, versus anxiety which prevents activity e.g. "I am anxious at the thought of going outside and falling in the garden and breaking a bone so I am not going to do gardening anymore." | |||
The individual may present with depression and low mood and not being able to participate in their usual ADLs and social roles as a result of their FOF. | |||
=== Risk Factors for FOF === | |||
These are the same as those for falls.<br> | |||
== Diagnostic Procedures == | == Diagnostic Procedures == | ||
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* Mobility in functional tasks e.g. transfers on/off chair and bed, walking indoors, walking outdoors, mobilising on steps, mobilising to and from bathroom | * Mobility in functional tasks e.g. transfers on/off chair and bed, walking indoors, walking outdoors, mobilising on steps, mobilising to and from bathroom | ||
* Balance (see below) | * Balance (see below) | ||
* Strength of trunk and limbs<br> | * Strength of trunk and limbs | ||
* Level of anxiety (see below)<br> | |||
== Outcome Measures == | == Outcome Measures == | ||
Revision as of 07:13, 25 September 2019
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Definition[edit | edit source]
A fear of falling (FOF) or post-fall syndrome is a person's anxiety towards usual or normal walking or mobilising, with the perception that a fall will occur. It is common after a fall although it can occur in the absence of a fall Vellas et al.
Falls are a significant cause of morbidity and mortality. Please see the Falls page for further detail.
Clinical Presentation[edit | edit source]
Functional Decline[edit | edit source]
The person may have had a fall or known someone who had a fall and sustained serious injuries. As a result, the person becomes fearful of moving in case they fall and hurt themselves. As a result, they will reduce their usual activities which can show up in a subjective of the person's recent activities or ADLs compared to what they, or a carer, report they used to do.
Reduced Mobility[edit | edit source]
The result of reduced ADLs leads to muscle weakness and loss of balance reactions which increases the person's actual chance of falling. Hence a FOF can become a "self-fulfilling prophecy" and a cycle of fear, reduced activity, reduced physical function, falls and injuries and so on.
Anxiety and Depression[edit | edit source]
In regards to anxiety, Harding et al distinguish between anxiety accompanying the activity e.g. nervous whilst walking outside down a steep path, versus anxiety which prevents activity e.g. "I am anxious at the thought of going outside and falling in the garden and breaking a bone so I am not going to do gardening anymore."
The individual may present with depression and low mood and not being able to participate in their usual ADLs and social roles as a result of their FOF.
Risk Factors for FOF[edit | edit source]
These are the same as those for falls.
Diagnostic Procedures[edit | edit source]
Subjective Assessment[edit | edit source]
This should include:
- Recent pattern of activity - days, months, year
- History of falls including incident, any subsequent treatment and rehabilitation, life changes (or not) after fall/s
- Current living situation
- Current mobility both in the home and in the community
- Descriptions of activities that cause the person anxiety
- Medications the person in currently taking
- Previous treatment for anxiety in general and if/how FOF has been treated in the past
Objective Assessment[edit | edit source]
This should include:
- Mobility in functional tasks e.g. transfers on/off chair and bed, walking indoors, walking outdoors, mobilising on steps, mobilising to and from bathroom
- Balance (see below)
- Strength of trunk and limbs
- Level of anxiety (see below)
Outcome Measures[edit | edit source]
Mobility[edit | edit source]
Balance[edit | edit source]
Strength[edit | edit source]
Anxiety[edit | edit source]
Management / Interventions[edit | edit source]
Resources[edit | edit source]
add appropriate resources here
