Relationships between fear of falling, balance confidence, and control of balance, gait, and reactive stepping in individuals with sub-acute stroke.
Fear of falling is common in individuals with stroke; however, the associations between fear of falling, balance confidence, and the control of balance and gait are not well understood for this population. This study aimed to determine whether, at the time of admission to in-patient rehabilitation, specific features of balance and gait differed between individuals with stroke who did and did not report fear of falling, and whether these features were related to balance confidence. Individuals with stroke entering in-patient rehabilitation were asked if they were afraid of falling, and completed the Activities-Specific Balance Confidence Scale. Participants performed quiet standing, gait, and reactive stepping tasks, and specific measures were extracted for each (quiet standing: centre of pressure amplitude, between-limb synchronization, and Romberg quotients; gait: walking velocity, double support time, and variability measures; reactive stepping: number of steps, frequency of grasp reactions, and frequency of assists). No significant differences were identified between individuals with and without fear of falling. Balance confidence was negatively related to centre of pressure amplitude, double support time, and step time variability, and positively related to walking velocity. Low balance confidence was related to poor quiet standing balance control and cautious behavior when walking in individuals with sub-acute stroke. While the causal relationship between balance confidence and the control of balance and gait is unclear from the current work, these findings suggest there may be a role for interventions to increase balance confidence among individuals with stroke, in order to improve functional mobility.
Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON, Canada M5G 2A2. Electronic address: alison.schinkel-ivy@uhn.ca.
Alison
A
Schinkel-Ivy
Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON, Canada M5G 2A2; University of Toronto, 500 University Ave., Toronto, ON, Canada M5G 1V7.
Elizabeth L
EL
Inness
Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON, Canada M5G 2A2; University of Toronto, 500 University Ave., Toronto, ON, Canada M5G 1V7; Evaluative Clinical Sciences, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, 2075 Bayview Ave., Toronto, ON, Canada M4 N 3M5.
Avril
A
Mansfield
D000058:Accidental Falls; D000368:Aged; D005239:Fear; D005260:Female; D020233:Gait Disorders, Neurologic / Q000503:physiopathology*; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000502:physiology*; D012189:Retrospective Studies; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology
Balance confidence; Fear of falling; Gait; Postural balance; Stroke