Schmid Arlene A, Acuff Marvin, Doster Kristen, Gwaltney-Duiser Amanda, Whitaker Amanda, Damush Teresa, Williams Linda, Hendrie Hugh
Roudebush VA Medical Center, Health Services Research and Development Center on Implementing Evidence-Based Practice, Indianapolis, Indiana, USA.
Top Stroke Rehabil. 2009 Sep-Oct;16(5):357-66. doi: 10.1310/tsr1605-357.
Fear of falling (FoF) has a negative impact on older adults, however there is a paucity of research regarding the development and impact of FoF after stroke. Therefore, our objectives were to determine the proportion of individuals with FoF and the affect of FoF during the immediate poststroke period.
This observational study of baseline data from a pilot cohort study includes a convenience sample of 28 adults with acute stroke before discharge home. Measures include self-reported FoF, the Falls Efficacy Scale-Swedish Version [FES(S)], Stroke-Specific Quality of Life (SS-QOL), performance and satisfaction with performance (Canadian Occupational Performance Measure), anxiety (Generalized Anxiety Disorder-7), and depression (Patient Health Questionnaire-9).
Fifteen (54%) of the participants reported FoF. Those with FoF were more likely to have decreased SS-QOL domain scores for energy (p = .013), personality (p = .015), and thinking (p = .008); decreased performance (self-care, productivity, and leisure) (p = .019) and satisfaction with performance (p = .010); and increased anxiety (p = .002) than those without FoF.
Those with FoF demonstrated significantly increased anxiety and showed decreased performance and satisfaction with performance, energy, thinking, and personality than those without FoF. This suggests that poststroke FoF is related not only to physical challenges but also to cognitive and emotional factors in the poststroke period. Identifying and treating these conditions should be evaluated as a means to decrease FoF and improve outcomes post stroke.
害怕跌倒（FoF）对老年人有负面影响，然而关于中风后害怕跌倒的发展及影响的研究却很匮乏。因此，我们的目标是确定害怕跌倒的个体比例以及中风后即刻期间害怕跌倒的影响。
这项对一项试点队列研究基线数据的观察性研究纳入了28名出院前急性中风成年人的便利样本。测量指标包括自我报告的害怕跌倒情况、瑞典版跌倒效能量表[FES(S)]、特定于中风的生活质量（SS-QOL）、表现及对表现的满意度（加拿大职业表现测量）、焦虑（广泛性焦虑障碍-7）和抑郁（患者健康问卷-9）。
15名（54%）参与者报告有害怕跌倒情况。与没有害怕跌倒的人相比，有害怕跌倒的人在精力（p = 0.013）、性格（p = 0.015）和思维（p = 0.008）方面的SS-QOL领域得分更可能降低；表现（自我护理、生产力和休闲）（p = 0.019）及对表现的满意度（p = 0.010）更低；焦虑程度更高（p = 0.002）。
与没有害怕跌倒的人相比，有害怕跌倒的人焦虑显著增加，表现及对表现的满意度、精力、思维和性格方面降低。这表明中风后害怕跌倒不仅与身体挑战有关，还与中风后的认知和情感因素有关。识别和治疗这些情况应作为降低害怕跌倒及改善中风后结局的一种手段进行评估。
