Johari Sahar, MacDermid Joy, Parikh Pulak, Grewal Ruby
School of Physical Therapy, Department of Health and Rehabilitation Sciences, University of Western Ontario, London, Ontario, Canada.
Clinical Research Lab, Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada.
J Geriatr Phys Ther. 2025;48(1):42-51. doi: 10.1519/JPT.0000000000000426. Epub 2024 Dec 23.
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.
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."
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.
This review highlighted the need for adopting more comprehensive approaches for assessing and addressing FoF in older adults with orthopedic conditions.
害怕跌倒（FoF）是对跌倒风险的持续焦虑，甚至会影响没有跌倒史的个体。害怕跌倒与身体功能下降和跌倒风险增加有关。大多数干预措施都集中在降低健康老年人的害怕跌倒程度上。本研究旨在回顾与骨科疾病老年患者害怕跌倒干预措施相关的文献范围、性质和内容。
进行了一项范围综述。方法步骤包括确定研究问题、识别相关研究、选择研究、绘制数据图表以及综合、总结和报告结果。检索了Cochrane图书馆、Medline、PsycINFO、Embase、ProQuest和谷歌学术。检索策略使用了一组关键概念，包括“害怕跌倒”、“骨科疾病”、“干预措施”和“老年人”。
在符合纳入标准的33篇文章中，21篇为随机对照试验（RCT），5篇为RCT方案，3篇为准实验研究，2篇采用前后设计，1篇为前瞻性队列研究，1篇为实验研究。该综述揭示了7种不同类别的干预措施：运动训练、认知行为疗法、强化职业或物理治疗（OT或PT）、动机访谈、跨学科干预、教育和身心干预。跌倒效能量表（FES）是评估害怕跌倒最常用的结局指标。其他指标包括害怕跌倒问卷（FoFQ）、国际体力活动问卷（IPAQ）和感知跌倒管理能力（PAMF）。这些研究在推理、内容以及报告结果的方式上各不相同，这给医疗保健专业人员选择和应用针对各种骨科疾病的害怕跌倒干预方案带来了挑战。
本综述强调了需要采用更全面的方法来评估和解决骨科疾病老年患者的害怕跌倒问题。
