title: Fear of falling in people with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Increased fear of falling (FOF) has been associated with impaired physical function, reduced physical activity and increased fall risk in older adults. Preliminary evidence suggests that individuals with chronic obstructive pulmonary disease (COPD) may have an increased FOF. This study aims to compare the level of FOF in people with COPD with healthy controls, and to determine the associations between FOF and measures of physical function, physical activity and fall risk in COPD.
  
  
  METHODS
  FOF was assessed in 40 participants with COPD and 25 age- and gender-matched controls using the Falls Efficacy Scale-International (FES-I). Physical function was evaluated using quadriceps hand-held dynamometry, the Berg Balance Scale and the Six-minute Walk Test. Associations between FOF, physical activity and fall risk were evaluated using the Physical Activity Scale for the Elderly and the Falls Risk in Older People - Community Setting. Pearson's correlation coefficient and stepwise multivariate linear regression were used.
  
  
  RESULTS
  Individuals with COPD (mean ± SD; age: 71 ± 8 years, FEV1: 45 ± 16 %pred) had higher FOF compared to controls (FES-I: 25.0 ± 7.9 vs 20.2 ± 5.2, p=0.01). Higher FOF was associated with lower quadriceps strength (p=0.02) and an impaired balance (p < 0.01); these explained 26% of the FOF variance. Reduced levels of physical activity (p=0.01) and a higher fall risk (p < 0.01) were associated with an increased FOF in COPD.
  
  
  CONCLUSIONS
  People with COPD have a higher FOF compared to the healthy peers, which is related to lower quadriceps muscle strength, impaired balance, lower levels of physical activity and an increased fall risk.
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Level 7, 161 Barry St, Melbourne, VIC 3010, Australia. Electronic address: cristinocoli@gmail.com.
authors.forename: Cristino C
authors.initials: CC
authors.lastname: Oliveira
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Level 7, 161 Barry St, Melbourne, VIC 3010, Australia. Electronic address: mcginley@unimelb.edu.au.
authors.forename: Jennifer
authors.initials: J
authors.lastname: McGinley
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Level 7, 161 Barry St, Melbourne, VIC 3010, Australia. Electronic address: annemarielee257@gmail.com.
authors.forename: Annemarie L
authors.initials: AL
authors.lastname: Lee
authors.affiliation: Department of Respiratory and Sleep Medicine, The Royal Melbourne Hospital, Level 1, 300 Grattan St, Melbourne, VIC 3050, Australia; Melbourne Medical School, The University of Melbourne, Level 2 West, Medical Building, Grattan St, Melbourne, VIC 3010, Australia. Electronic address: louis.Irving@mh.org.au.
authors.forename: Louis B
authors.initials: LB
authors.lastname: Irving
authors.affiliation: Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Level 7, 161 Barry St, Melbourne, VIC 3010, Australia. Electronic address: l.denehy@unimelb.edu.au.
authors.forename: Linda
authors.initials: L
authors.lastname: Denehy
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000368:Aged; D001315:Australia / Q000453:epidemiology; D001526:Behavioral Symptoms / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005080:Exercise Test / Q000379:methods; D005239:Fear; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D009043:Motor Activity; D053580:Muscle Strength; D010045:Outpatients; D004856:Postural Balance; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012129:Respiratory Function Tests; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
keywords: Accidental falls; Chronic obstructive; Fear; Motor activity; Postural balance; Pulmonary disease