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      Clinical Interventions in Aging (submit here)

      This international, peer-reviewed Open Access journal by Dove Medical Press focuses on prevention and treatment of diseases in people over 65 years of age. Sign up for email alerts here.

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      The development of a fear of falling interdisciplinary intervention program

      research-article
      ,
      Clinical Interventions in Aging
      Dove Medical Press
      fear of falling, elderly programs, Colombian, intervention

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          Abstract

          Objective:

          To describe the development process of a protocol for a fear of falling interdisciplinary intervention program based on the main factors associated with fear of falling.

          Design/methods:

          The process of developing a protocol consisted of defining the target population, selecting the initial assessment components, adapting the intervention program based on findings about fear of falling and restriction of activities in this population.

          Settings:

          University-affiliated outpatient vertigo, dizziness and falls clinic in coffee-growers zone of Colombian Andes Mountains.

          Results:

          An intervention program was developed based on three main falling conceptual models. A medical intervention, based on a biomedical and pathophysiological model, a physiotherapeutic intervention based on a postural control model and a psychological intervention based on a biological-behavioral model.

          Conclusion:

          This interdisciplinary fear of falling intervention program developed is based on particular characteristics of target population, with differences in the inclusion criteria and the program intervention components; with emphasis on medical (recurrent falls and dizziness evaluation and management), psychological (cognitive-behavioral therapy) and physiotherapeutic (balance and transfers training) components.

          Most cited references56

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          Falls efficacy as a measure of fear of falling.

          We developed the Falls Efficacy Scale (FES), an instrument to measure fear of falling, based on the operational definition of this fear as "low perceived self-efficacy at avoiding falls during essential, nonhazardous activities of daily living." The reliability and validity of the FES were assessed in two samples of community-living elderly persons. The FES showed good test-retest reliability (Pearson's correlation 0.71). Subjects who reported avoiding activities because of fear of falling had higher FES scores, representing lower self-efficacy or confidence, than subjects not reporting fear of falling. The independent predictors of FES score were usual walking pace (a measure of physical ability), anxiety, and depression. The FES appears to be a reliable and valid method for measuring fear of falling. This instrument may be useful in assessing the independent contribution of fear of falling to functional decline among elderly people.
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            A Randomized, Controlled Trial of a Group Intervention to Reduce Fear of Falling and Associated Activity Restriction in Older Adults

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              Postural control in the older adult.

              Age-related changes in the neural, sensory, and musculoskeletal systems can lead to balance impairments that have a tremendous impact on the ability to move about safely. The many complex substrates of the posture control system subserve a common functional goal: regulation of the relationship between the center of mass and the base of support. Traditional approaches, which have focused on the control of the center-of-mass displacement, have documented age-related changes in "feet-in-place" responses: during quiet standing, during volitional movement, or in response to applied perturbation. Recently, increasing attention has been directed toward the control of the base of support, that is, compensatory leg and arm movement, as an important element of the postural repertoire, and early results suggest profound age-related impairment in the control of compensatory stepping movements. For both feet-in-place and stepping responses, control of lateral stability appears to be a major problem associated with increased risk of falling. In view of age-related differences in ability to adapt postural responses under predictable task conditions, future work will likely benefit by mimicking, as much as possible, the varied and unpredictable nature of the events that often precipitate falls in daily life, in order to draw connections between the laboratory or clinic and "real-life" stability.
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                Author and article information

                Journal
                Clin Interv Aging
                Clinical Interventions in Aging
                Clinical Interventions in Aging
                Dove Medical Press
                1176-9092
                1178-1998
                December 2007
                December 2007
                : 2
                : 4
                : 661-667
                Affiliations
                Research Group on Gerontology and Geriatrics, Health Sciences Faculty, University of Caldas, Manizales, Colombia
                Author notes
                Correspondence: Fernando Gomez, Research Group on Gerontology and Geriatrics, Health Sciences Faculty, Cra. 24 Calle 56, University of Caldas, Manizales, Colombia, Fax +57 6 5768 851981, Email fercho7@ 123456telesat.com.co
                Article
                cia-2-661
                2686320
                18225468
                93af0cb7-612d-4f27-a9bf-bffb96ce0f5f
                © 2007 Dove Medical Press Limited. All rights reserved
                History
                Categories
                Original Research

                Health & Social care
                colombian,elderly programs,intervention,fear of falling
                Health & Social care
                colombian, elderly programs, intervention, fear of falling

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