title: Fear of falling after brain injury.
abstract: OBJECTIVE
  To investigate the prevalence and nature of fear of falling in a sample of people with severe acquired brain injury.
  
  
  METHODS
  A descriptive study.
  
  
  METHODS
  A regional inpatient neurological rehabilitation unit.
  
  
  METHODS
  One hundred and five adults with acquired brain injury of mixed aetiology.
  
  
  METHODS
  All 105 participants were rated by observers who were asked to judge the degree to which fear behaviour interfered with rehabilitation therapy (activity limitation). Eighty-two participants also rated themselves. They were asked to report the degree of distress caused by fear. Both participants and observers were asked to describe the focus of any reported fear. Two stepwise logistic regression analyses were carried out to identify variables that predicted fear giving rise to significant activity limitation and fear giving rise to significant subjective distress.
  
  
  METHODS
  Self and observer rating scales designed and constructed specifically for the study.
  
  
  RESULTS
  Raters reported significant fear-related activity limitation in 12-15% of participants. Significant fear-related subjective distress was reported by 40% of participants. Fear of falling, fear of physical harm and fear of not making sufficient rehabilitation progress dominated the reports of both observers and participants. The variables predicting significant activity limitation were premorbid alcohol misuse, low functional ability and the occurrence of a fall since onset. The variables predicting significant subjective distress were poor motor coordination and organization, and good verbal comprehension.
  
  
  CONCLUSIONS
  Fear of falling is a clinically significant phenomenon in younger adults recovering from severe acquired brain injury. Fear sufficient to cause high degrees of subjective distress was often not evident to observers. Proactive questioning about fear of falling is therefore advisable when working clinically with this group.
authors.affiliation: Oxford Centre for Enablement, Oxford, UK. j.collicutt@heythrop.ac.uk
authors.forename: Joanna
authors.initials: J
authors.lastname: Collicutt McGrath
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation*; D015331:Cohort Studies; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D010698:Phobic Disorders / Q000453:epidemiology* / Q000523:psychology / Q000628:therapy; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome