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A Scoping Review of Interventions Aimed at Reducing Fear of Falling in Older Adults With Orthopedic Conditions. | LitMetric

A Scoping Review of Interventions Aimed at Reducing Fear of Falling in Older Adults With Orthopedic Conditions.

J Geriatr Phys Ther

Roth McFarlane Hand and Upper Limb Center, St. Joseph's Health Centre, University of Western Ontario, London, Ontario, Canada.

Published: December 2024

AI Article Synopsis

  • Fear of falling (FoF) is a common anxiety that affects older adults, particularly those with orthopedic conditions, leading to decreased physical functioning and an increased risk of actual falls.
  • A scoping literature review analyzed existing interventions targeting FoF, revealing 33 relevant studies, including various randomized control trials and other research designs.
  • The review identified seven intervention categories, such as exercise training and cognitive-behavioral therapy, and highlighted the Falls Efficacy Scale as the primary measure used to evaluate outcomes, though inconsistencies in study content make it challenging for healthcare professionals to choose the best interventions.

Article Abstract

Background And Purpose: Fear of falling (FoF) is a persistent anxiety regarding the risk of falling, which can even impact individuals without a history of falls. Fear of falling has been associated with decreased physical functioning and increased risk of falls. Most interventions have focused on reducing FoF in healthy older adults. This study aimed to review the literature's scope, nature, and content related to FoF interventions in older adults with orthopedic conditions.

Methods: A scoping literature review was conducted. The method steps included identifying the research question, identifying relevant studies, selecting the studies, charting the data, and synthesizing, summarizing, and reporting the results. Cochrane Library, Medline, PsycINFO, Embase, ProQuest, and Google Scholar were searched. The search strategy used a set of key concepts, including "Fear of Falling," "Orthopedic conditions," "Interventions," and "Older adults."

Results And Discussion: Out of the 33 articles that fulfilled the inclusion criteria, 21 were randomized control trials (RCTs), 5 were RCT protocols, 3 were quasi-experimental studies, 2 employed pre-post designs, 1 was a prospective cohort study, and 1 was an experimental study. The review revealed 7 distinct categories of interventions: exercise training, cognitive behavioral therapy, enhanced occupational or physical therapy (OT or PT), motivational interviews, interdisciplinary interventions, education, and mind-body intervention. The Falls Efficacy Scale (FES) was the most frequently used outcome measure for assessing FoF. Other measures were the Fear of Falling Questionnaire (FoFQ), the International Physical Activity Questionnaire (IPAQ), and the Perceived Ability to Manage Fall (PAMF). The studies varied in their reasoning, content, and how they reported findings, posing challenges for healthcare professionals in choosing and applying FoF intervention programs specific to various orthopedic conditions.

Conclusion: This review highlighted the need for adopting more comprehensive approaches for assessing and addressing FoF in older adults with orthopedic conditions.

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Source
http://dx.doi.org/10.1519/JPT.0000000000000426DOI Listing

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