Department of Rehabilitation Medicine, Tokyo Bay Rehabilitation Hospital, Narashino.
Faculty of Rehabilitation, School of Health Sciences.
Int J Rehabil Res. 2020 Dec;43(4):383-385. doi: 10.1097/MRR.0000000000000425.
We present the case of a 42-year-old man with subacute stroke who developed remarkable fear of falling and eventually recovered with an approach based on cognitive behavioral therapy (CBT). The CBT-based approach was implemented after the patient developed significant fear of falling with exacerbated obsessive-compulsive symptoms appeared immediately after a fall. The patient's anxiety decreased over time, and his ability to perform these tasks and activities of daily living improved accordingly. After 6 weeks of intervention, his anxiety toward gait and stairs almost disappeared; additionally, he achieved modified independence for gait and supervision for stairs and was discharged home successfully. These findings in the present case suggest the effectiveness of an evaluation and interventional approach based on CBT for stroke patients with a severe fear of falling.
我们报告了一例 42 岁亚急性脑卒中患者,他出现了明显的恐摔,并最终通过认知行为疗法(CBT)得到了康复。在患者跌倒后出现明显的恐摔和明显的强迫症状后,采用了基于 CBT 的方法。随着时间的推移,患者的焦虑逐渐减轻,他完成这些任务和日常生活活动的能力也相应提高。经过 6 周的干预,他对步态和楼梯的恐惧几乎消失;此外,他在步态方面实现了改良独立和楼梯方面的监督,成功出院回家。本病例的这些发现提示,基于 CBT 的评估和干预方法对有严重恐摔的脑卒中患者是有效的。