Integrated Exposure Therapy and Exercise Reduces Fear of Falling and Avoidance in Older Adults: A Randomized Pilot Study.

<bold>Objectives: </bold>To evaluate the safety and acceptability of a novel 8-week intervention integrating exercise, exposure therapy, cognitive restructuring, and a home safety evaluation, conducted by a physical therapist, in reducing fear of falling and activity avoidance. To collect preliminary evidence of efficacy.<bold>Design: </bold>Randomized pilot study comparing the intervention to time- and attention-equivalent fall prevention education.<bold>Setting: </bold>Participants' homes.<bold>Participants: </bold>42 older adults with disproportionate fear of falling (high fear, low to moderate objective fall risk).<bold>Measurements: </bold>Falls Efficacy Scale-International, modified Activity Card Sort, satisfaction, falls.<bold>Results: </bold>Relative to education, the intervention reduced fear of falling (d = 1.23) and activity avoidance (d = 1.02) at 8 weeks, but effects eroded over a 6-month follow-up period. The intervention did not increase falls, and participants rated the exercise, exposure therapy, and non-specific elements as most helpful.<bold>Conclusions: </bold>An integration of exercise and exposure therapy may help older adults with disproportionate fear of falling, but modifications to the intervention or its duration may be needed to maintain participants' gains. [ABSTRACT FROM AUTHOR]