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Background: Social participation levels of individuals with Multiple Sclerosis (iwMS) are lower than those of healthy individuals. Objective: This study aimed to evaluate to which extent the walking capacity, balance, and fear of falling (FoF) affect the community integration levels of iwMS. Methods: Thirty-nine iwMS were evaluated for their participation levels [The Community Integration Questionnaire (CIQ)], walking capacity [The Six-Minute Walk Test (6MWT)], balance [Kinesthetic Ability Trainer (SportKAT®)], and FoF [The Modified Falls Efficacy Scale (MFES)]. Correlation and regression analyses were performed to detect the effects of SportKAT®, 6MWT, and MFES on CIQ. Results: CIQ scores were significantly correlated with 6MWT (p =.043) and MFES (p =.005) scores, while CIQ was not related with static (for two feet test p =.356, for right single-leg stance test p =.412, for left single-leg stance test p =.730) and dynamic balance (for clockwise test p =.097, for counterclockwise test p =.540) measured with the SportKAT®. It was found that CIQ could be predicted by 6MWT and MFES at the level of 16% and 25%, respectively. Conclusion: FoF and walking capacity are associated with community integration in iwMS. Therefore, physiotherapy and rehabilitation programs of iwMS should be combined with treatment goals to increase community integration, balance, and gait and decrease the disability and FoF from an early stage. Comprehensive studies examining other factors that may impact participation in iwMS with different levels of disability are needed. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the prevalence of fear of falling and associated factors in older adults with heart failure. Methods: A prospective, cross‐sectional study. The study included 100 geriatric patients who were hospitalised and treated in the cardiology department of our hospital with ventricular ejection fraction (LVEF) lower than 50% for at least 1 year. A series of geriatric assessments were performed by face‐to‐face interview on the day of admission. Electrocardiography (ECG) and transthoracic echocardiography (TTE) were also performed on the day of admission. Results: The median age of the patients was 72 years, and 72.0% were men. Falls Efficacy Scale scores indicated a fear of falling in 46 (46.0%) of the patients. Charlson Comorbidity Index (CCI) was significantly higher in patients with fear of falling (P < 0.001). Severe depression, severe clinical insomnia, daytime sleepiness, and malnutrition were significantly more frequent among patients with fear of falling. Fear of falling was associated with significantly lower LVEF (P = 0.001). The presence of severe depression increased the risk of fear of falling by 13.97 times (95% CI: 3.064–63.707; P = 0.001), and the presence of daytime sleepiness increased the risk by 3.49 times (95% CI: 1.012–12.037; P = 0.048). A one‐unit increase in CCI increased the risk of fear of falling by 1.56 times (95% CI: 1.093–2.238; P = 0.014). Conclusions: Heart failure patients with concomitant depression, sleep disorders, and high comorbidities have greater fear of falling. [ABSTRACT FROM AUTHOR]

Kinesiophobia is defined as the fear of movement and activity resulting from a feeling of vulnerability to painful injury or re-injury. This study aimed to determine the effect of kinesiophobia on physical activity, balance, and fear of falling in patients with Parkinson's disease. The study, which was designed as a cross-sectional type, was conducted with 86 patients with Parkinson's disease (age 61.25 SD [9.72] years old) by face-to-face interviews with the patients. The Tampa Scale of Kinesiophobia, International Physical Activity Questionnaire-Short Form, Berg Balance Scale, Falls Efficacy Scale, Visual Analog Scale – Fear of Falling, Unified Parkinson's Disease Rating Scale – motor score, and the Hoehn and Yahr scale were used to evaluate the patients. Patients with Parkinson's disease who had high levels of kinesiophobia had lower levels of physical activity, worse balance, and higher disease severity and fear of falling. A correlation was found between the Tampa Scale score and physical activity, balance, fear of falling, falls efficacy, and disease motor score (p <.001; r = −0.38, −0.54, 0.67, 0.57, and 0.37, respectively). According to multiple linear regression analysis, kinesiophobia explained the dependent variables to varying degrees ranging from 13% to 44% (p <.001). Patients with Parkinson's disease may have kinesiophobia. Rehabilitation programs to support functional capacity for these patients should be developed considering the presence of kinesiophobia. [ABSTRACT FROM AUTHOR]

Background and Purpose: Fear of falling is the worry that appears with the fall, and it is quite commonly seen in older adults. The aim of the study was to detect the fear of falling and related factors in older persons who are receiving home care services provided by Bornova Municipality. Methods: This cross-sectional study was conducted with the participation of 386 individuals older than 60 years. The data were collected via face-to-face interviews by a questionnaire form, May-October, 2018. The fear of falling was measured by The Falls of Efficacy Scale-International. In addition, a questionnaire to collect sociodemographic data, retrospective history of falls, Instrumental Activities of Daily Living, EuroQol-5D, and Home Security Control List was used. Results: The mean age of the sample was 77.66 ± 7.59 years and females constituted 74.6% of them. Of the participants, 74.1% were detected to have fear of falling. The logistic regression analysis showed a significant association between the fear of falling and fall history, quality of life, and health status visual analog scale scores. Conclusion: It can be argued that the fear of falling is higher in the individuals who have a past experience of falling and the individuals who have a low quality of life. The older adults who have falls history should be determined as a risk group and protective measures should be applied to enhance their life quality. [ABSTRACT FROM AUTHOR]

Copyright of Ahi Evran Medical Journal is the property of Ahi Evran University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The Iconographical Falls Efficacy Scale (Icon-FES) is the first scale that consists of visual expressions and evaluates the fear of falling. The study aims to adapt the scale to Turkish. The Icon-FES, the Falls Efficacy Scale International, and the Activities-specific Balance Confidence Scale were applied to 150 older adults. The study indicated that Icon-FES has excellent psychometric properties. Presence of chronic diseases was found to be associated factors affecting the fear of falling (P <.05). The short-version Icon-FES-Turkish is a valid and reliable scale and it should be carried out on illiterate older adults. [ABSTRACT FROM AUTHOR]

Objective: To investigate level of kinesiophobia and related factors in postmenopausal women with osteoporosis (OP) and osteopenia (OPN). Materials and Methods: A total of 60 female patients with postmenopausal OP, 60 female patients with postmenopausal OPN and 60 age- and gender-matched controls were enrolled in this study. Demographic data (age, weight, height, body mass index, educational level, employment status, disease duration and menopause duration) of the participants were recorded. In all participants, the level of kinesiophobia, fear of falling, psychological status, health-related quality of life and osteoporosis self-efficacy were evaluated using the Tampa scale of kinesiophobia (TSK), falls efficacy scale-international (FES-I), hospital anxiety and depression scale (HADS), quality of life questionnaire of the European Foundation for Osteoporosis-41 (QUALEFFO-41) and osteoporosis self-efficacy scale (OSES), respectively. Results: Postmenopausal patients with OP and OPN had higher levels of kinesiophobia than controls (p<0.05). However, there was no difference between the levels of kinesophobia in patients with OP and OPN (p>0.05). In addition, a positive correlation was found between TSK score and FES-I, HADS, QUALEFFO-41 scores and duration of menopause, and a negative correlation between OSES scores in patients with OP and OPN (p<0.05). Patients were divided into two groups according to their kinesiophobia levels: High and low kinesiophobia groups. All clinical parameters were negatively affected in patients in the high kinesophobia group (p<0.05). Conclusion: Both OP and OPN may cause kinesiophobia in postmenopausal women. Increased fear of falling, impaired psychological status, poor quality of life, decreased perception of self-efficacy and prolonged duration of menopause in postmenopausal women with OP and OPN seem to be associated with a higher level of kinesiophobia. As physical activity is essential for bone health, postmenopausal women with OP and OPN should be counselled about the importance of overcoming kinesiophobia. [ABSTRACT FROM AUTHOR]

Falling with increasing age is a health problem which causes high mortality and morbidity in elderly. Falls affect individuals physiologically and psychologically negatively. Causes of falls are due to internal and external factors. Within the scope of the TUBITAK 1001 Project No.115M548 titled as “Anthropometric Dimensions of the Elderly People of Anatolia”; data were collected from 2721 individuals in seven regions and 26 provinces of both sexes and three age groups (65-74, 75-84, 85+). All the acquired data will be transferred to the database with an evaluation of SPSS 22.00 program so a data bank has constituted for falling situations and demographic information of older adults in Turkey. According to the research, there was a statistically significant relationship between falling and gender and regions. Falls are more common in women than men. The regions with the highest fall rates are Black Sea and Southeastern Anatolia. In addition, a statistically significant relationship was found between the fear of falling increases in women by age, and it is highest in the Black Sea region. A statistically significant positive correlation was found between age and injuries. It was also found that women were injured more than men and fractures occurred due to falls. In addition, participants aged 85 and over mostly experienced falling within the dwelling, while individuals in the 65-74 and 75-84 age groups fell more in the environment. There were more falls in the dwelling for women and in the environment for men. Risk factors for falls that cause high morbidity and mortality with the increasing age should be determined, and individuals’ participation in social life should be supported by making indoor and outdoor arrangements. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The aim of this quantitative study was to assess falls and fear of falling in patients with knee osteoarthritis, and to determine their effects on daily activities. Design: A descriptive and prospective quantitative study. Methods: The study employed a descriptive and prospective design, examining 93 patients with knee osteoarthritis. We used the Lequesne Index (LI), the Falls Efficacy Scale (FES), and the Visual Analog Scale for Fear of Falling (VAS-FOF) to assess the effects of falls and fear of falling on daily activities. Results: The mean age of participants was 62.0 years old. In total, 78.5% of patients had experienced falls in the past, 53.4% of whom were admitted to hospital as a result. There was a positive significant correlation between total mean Lequesne Index and VAS-FOF scores, age, and BMI of participants (r = 0.310; r = 0.231; r = 0.283) (p < 0.05). A negative correlation was found between FES and VAS-FOF scores, total LI score, and age (p < 0.05). In addition, a negative significant correlation was found between age and BMI (r = -0.257) (p < 0.013). Conclusion: The results demonstrated that fear of falling affects the performance of daily activities. Knee osteoarthritis is an important risk factor for falling, and falls affect daily activities in those with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: Falls tend to create fear and concern in older adults who also seek care in emergency departments (EDs) at high rates. Aim: The purposes of this study were to (a) describe risk and fear of falling in older adults seeking care in the ED and (b) explore relationships between risk and fear of falling with activities of daily living and quality of life. Methods: The study was conducted in the ED of Ondokuz May's University Hospital in Samsun, Turkey. Data were collected for 7 months in 2013-2014. Adults aged 65 years and above who scored at least 20 on the Standardized Mini-Mental Test and who presented for care in the ED were eligible to take part. Patients self-reported demographic information and completed the Tinetti Falls Efficacy Scale, the Morse Fall Scale, the Nottingham Health Profile (NHP), and the Modified Barthel Index (MBI). Results: A total of 151 older adults took part. Prevalence of falls was high (48.3%), as well as fear of falling (63.6%). Risk of falling (Morse Fall Scale scores) was negatively correlated with the ability to carry out activities of daily living (MBI scores; r = -.50, p < .001) and positively related to scores on the NHP (r = .45, p < .001); likewise, fear of falling (Falls Efficacy Scale scores) was negatively correlated with the ability to carry out activities of daily living (MBI scores; r = -.79, p < .001) and positively correlated with NHP scores (r = .64, p < .001). Discussion: Older adults seeking care in the ED who have a higher risk of falling are more dependent in daily living activities and experience lower quality of life. Care seeking in the ED offers an opportunity to assess fall risk and fear of falling and provide guidance on prevention and management of falls in older adults. [ABSTRACT FROM AUTHOR]

Abstract: The FES-I is a questionnaire which was developed to assess fear of falling. The aim of this study was to evaluate validity and reliability of a Turkish language version of the FES-I in Turkish older people. The study sample included 70 volunteers with an age range of 65–81. To assess the test–retest reliability of the Turkish FES-I, questionnaire was applied again 10–15 days after the first interview (interclass correlation: ICC). FES-I was compared with The Modified Barthel Index (MBI), the timed up and go test (TUG), and The Berg Balance Scale (BBS) for construct validity. Cronbach''s alpha (α) was used to evaluate the internal consistency. The internal structure of the FES-I was examined by factor analysis. ROC plots were used to define cut-point for the FES-I scales. Cronbach''s α of the Turkish FES-I was 0.94 and the individual item ICC ranged from 0.97 to 0.99. The Turkish FES-I total scores were correlated with TUG positively, and MBI, and BBS negatively. The cut-off score to differentiate between persons with fear of falling and persons without fear of falling was 24 points. It was found that the Turkish version of the FES-I was a reliable and valid measure of fear of falling in Turkish older people. [Copyright &y& Elsevier]

Background/aim: The factors associated with fall-related self-efficacy should be addressed, especially in the elderly. The Modified Falls Efficacy Scale (MFES) is a simple instrument with good scaling properties and reliability. The aim of the present study was to determine the reliability and the validity of the Turkish version of the MFES from the viewpoint of balance., Materials and Methods: In this study, 164 participants aged >65 years were included. The use of walking aids and assistive devices, history and frequency of falls in the previous year, living environment, and exercise habits were noted. Balance and risk of falling were assessed with the Berg Balance Scale (BBS). A forward-backward translation procedure was used for the Turkish version of the MFES., Results: None of the 14 items in the MFES were modified. The Turkish version of the MFES has excellent internal consistency (Cronbach’s alpha, 0.978) and reliability (interclass correlation coefficient, 0.928–0.982), and its construct validity was supported by its ability to distinguish between the groups with respect to fall-risk factors and balance. According to the BBS scores, the high-fall-risk group had lower MFES scores than the moderate- and low-fall-risk groups (χ2 = 34.153, P = 0.001)., Conclusion: The Turkish version of the MFES is a sensitive instrument for evaluation of fall-related confidence while carrying out indoor/outdoor activities. It also predicts falls, reduced physical activity, balance and mobility problems, and restricted social participation and daily living activities., Competing Interests: No conflict of interest was declared by the authors., (This work is licensed under a Creative Commons Attribution 4.0 International License.)

Abstract: Falling is a major complication seen in stroke patients. The purpose of this study was to investigate the frequency, features, and factors for falls affecting subacute stroke patients hospitalized for rehabilitation. Ninety-nine subacute stroke patients, hospitalized for rehabilitation were evaluated prospectively in this study. All patients were evaluated using the functional independence measurement (FIM), the Barthel index (BI), the Berg balance scale (BBS), the mini mental state examination (MMSE), the hospital anxiety depression scale (HADS), and the Downton index (DI), performed by the same physician. Proximal femur bone mineral density (BMD) measurements were performed using the dual-energy X-ray absorbtiometry (DXA). During the period of hospitalization, 17 patients (17.2%) reported falling once. The calculated incidence rate for falls was 6.3/1000 hospital days (95% confidence interval, CI=3.7–10.1). Furthermore, 41% of the falls occurred in patients’ rooms, 82% between the hours 06:00– 20:00, 47% while walking and 65% on the side affected from the stroke. Despite the fact that 30% of the patients had osteoporosis, no fractures were observed after these falls, 88% had only soft tissue injury. Overall, 88% of the patients reported they had a fear for falling. Admission DI scores were significantly lower in the group of patients with no falls compared to the group with falls (p <0.05). Falls occurred most frequently during daytime, while subacute stroke patients were walking. DI is useful in stroke patients that are to be hospitalized for rehabilitation and accordingly, preventive action taken on those patients with a high risk for falls. [Copyright &y& Elsevier]