Wetherell Julie Loebach, Johnson Kristen, Chang Douglas, Ward Samuel R, Bower Emily S, Merz Caroline, Petkus Andrew J
VA San Diego Healthcare System, San Diego, CA, USA.
University of California, San Diego, CA, USA.
Int J Geriatr Psychiatry. 2016 Jul;31(7):791-8. doi: 10.1002/gps.4393. Epub 2016 Jan 4.
Fear of falling is an important problem among older adults, even those with relatively low rates of objective fall risk, who are often overlooked as targets for intervention.
We developed and pilot tested a new intervention, Activity, Balance, Learning, and Exposure (ABLE), in a sample of 10 older adults with excessive fear of falling. The ABLE intervention integrates exposure therapy and cognitive restructuring with a home safety evaluation and an exercise program and is conducted in the home. In this pilot project, ABLE was jointly conducted by a physical therapist and a psychologist with expertise in geriatric anxiety disorders.
The intervention was feasible and acceptable and resulted in decreases in fear and activity avoidance for most participants. One participant experienced an injurious fall.
We learned a number of important lessons resulting in modifications to the inclusion criteria, assessments, and intervention over the course of this pilot study. Results suggest that ABLE has promise for treating excessive fear of falling in the elderly and support testing the intervention in a larger randomized trial. Copyright © 2016 John Wiley & Sons, Ltd.
害怕跌倒在老年人中是一个重要问题,即使是那些客观跌倒风险相对较低的老年人,他们常常被忽视作为干预目标。
我们开发并初步测试了一种新的干预措施,即活动、平衡、学习与暴露(ABLE),对10名过度害怕跌倒的老年人进行了抽样测试。ABLE干预将暴露疗法和认知重建与家庭安全评估及锻炼计划相结合,并在家庭中实施。在这个试点项目中,ABLE由一名物理治疗师和一名在老年焦虑症方面有专业知识的心理学家共同实施。
该干预措施可行且可接受,大多数参与者的恐惧和活动回避行为有所减少。一名参与者发生了有伤害性的跌倒。
在这个试点研究过程中,我们吸取了一些重要经验教训,从而对纳入标准、评估和干预措施进行了修改。结果表明,ABLE有望治疗老年人过度害怕跌倒的问题,并支持在更大规模的随机试验中对该干预措施进行测试。版权所有© 2016约翰威立父子有限公司。