Development of a Scale to Assess Avoidance Behavior Due to a Fear of Falling: The Fear of Falling Avoidance Behavior Questionnaire (original) (raw)
Related papers
Journal of the American Geriatrics Society, 2000
OBJECTIVES: To compare the psychometric properties of the Activities-specific Balance Confidence Scale (ABC) and the Survey of Activities and Fear of Falling in the Elderly (SAFE). DESIGN: Secondary analysis using baseline and 12-week data from a randomized, controlled trial on fall prevention. SETTING: Upper Midwest metropolitan area with assessments conducted in participants' homes. PARTICIPANTS: Population-based sample of 272 noninstitutionalized female Medicare beneficiaries aged 70 and older at risk of falling. MEASUREMENTS: Participants self-administered the ABC, SAFE, Geriatric Depression Scale, and Medical Outcomes Study 36-item Short Form Survey. During a home visit, a nurse practitioner administered the Berg Balance Test and Timed Up and Go, measured gait speed, and asked about falls and chronic illnesses. RESULTS: Baseline internal consistency measured using Cronbach alpha was 0.95 for the ABC and 0.82 for the SAFE. Baseline concurrent validity between the ABC and SAFE measured using a correlation coefficient was À0.65 (Po.001). ABC and SAFE scores were significantly correlated at baseline with physical performance tests and self-reported health status. The ABC had stronger baseline correlations than the SAFE with most measures. Neither instrument demonstrated responsiveness to change at 12 weeks. CONCLUSION: The ABC and SAFE demonstrated strong internal-consistency reliability and validity when self-administered. The ABC had stronger associations with physical functioning and may be more appropriate for studies focused on improving physical function. Both instruments demonstrated ceiling effects, which may explain the lack of responsiveness to change in relatively nonfrail older women. Instruments sensitive to measuring lower levels of fear of falling are needed to capture the full range of this phenomenon in this population. J Am Geriatr Soc 56: 328-333, 2008.
2006
Balance is an important issue in aging research since it is undoubtedly linked with motor performance affecting, thus, activities of daily living and consecutively the quality of life in the elderly. Maintenance of good balance ability reduces the chance of a fall which, especially in the elderly, is not only an important predictor of mortality but also a major problem with important negative health and socio-economic consequences. The fear of falling, on the other hand, results in restrictions of physical activity, functional ability, and consequently may lead to reduced quality of life and adverse health consequences [5]. Another psychological variable linked to the fear of falling is balance confidence or falls self-efficacy, which refers to personal beliefs in one’s ability to engage in certain activities of daily living without falling or losing balance [8]. Increased balance confidence, which is determined to a great extent by balance performance [2], is associated with lower ...
Archives of Gerontology and Geriatrics, 2010
A shortened version of the ABC 16-item scale (ABC-16), the ABC-6, has been proposed as an alternative balance confidence measure. We investigated whether the ABC-6 is a valid and reliable measure of balance confidence and examined its relationship to balance impairment and falls in older adults. Thirty-five community-dwelling older adults completed the ABC-16, including the six questions of the ABC-6. They also completed the following clinical balance tests: unipedal stance time (UST), functional reach (FR), Timed Up and Go (TUG), and maximum step length (MSL). Participants reported twelve-month falls history. Balance confidence on the ABC-6 was significantly lower than on the ABC-16, however scores were highly correlated. Fallers reported lower balance confidence than non-fallers as measured by the ABC-6 scale, but confidence did not differ between the groups with the ABC-16. The ABC-6 significantly correlated with all balance tests assessed and number of falls. The ABC-16 significantly correlated with all balance tests assessed, but not with number of falls. Test-retest reliability for the ABC-16 and ABC-6 was good to excellent. The ABC-6 is a valid and reliable measure of balance confidence in community-dwelling older adults, and shows stronger relationships to falls than does the ABC-16. The ABC-6 may be a more useful balance confidence assessment tool than the ABC-16.
Physical therapy, 2015
Evidence suggests that there are several fall predictors in the elderly, including previous fall history and balance impairment. To date, however, the role of psychological factors have not yet been thoroughly vetted in conjunction with physical factors as predictors of future falls. To determine which measures, physical and psychological, are most predictive of falling in older adults. Prospective cohort. Sixty-four participants (age 72.2±7.2 years; 40 women, 24 men) with and without pathology (25 healthy, 17 with Parkinson's disease, 11 with cerebrovascular accident, 6 with diabetes, and 5 with a cardiovascular diagnosis) participated. Participants reported fall history and completed physical-based measures (i.e., Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Self-Selected Gait Velocity (SSGV), Timed Up and Go Test (TUGT), Sensory Organization Test (SOT)) and psychological-based measures (i.e., Fear of Falling Avoidance Belief Questionnaire (FFABQ), Falls Efficacy Scale ...
Determinants of balance confidence in community-dwelling elderly people
Physical therapy, 2003
The fear of falling can have detrimental effects on physical function in the elderly population, but the relationship between a persons' confidence in the ability to maintain balance and actual balance ability and functional mobility is not known. The extent to which balance confidence can be explained by balance performance, functional mobility, and sociodemographic, psychosocial, and health-related factors was the focus of this study. The subjects were 50 community-dwelling elderly people, aged 65 to 95 years (mean=81.7, SD=6.7). Balance was measured using the Berg Balance Scale. Functional mobility was measured using the Timed Up Go Test. The Activities-specific Balance Scale was used to assess balance confidence. Data were analyzed using Pearson correlation, multiple regression analysis, and t tests. Fifty-seven percent of the variance in balance confidence could be explained by balance performance. Functional mobility and subject characteristics examined in this study did n...
Archives of gerontology and geriatrics
The Activities specific Balance Confidence (ABC) is a questionnaire which was developed to assess falls-associated self-efficacy. The aim of this study was to evaluate reliability and validity of the German abbreviated 6-item version of the ABC scores in community-dwelling older people. The study sample included 384 subjects (age 71.1 ± 9.7). In order to determine the psychometric properties, reliability and validity were assessed through administration of the German adaptation of the ABC-D16 to participants twice, 10 days apart, and comparison of the ABC-D16 and the ABC-D6 with functional measures of balance and mobility (one-leg stance; 10 m walk; TUG; Fullerton Advanced Balance Scale (FAB)), physical activity (Physical Activity Scale for the Elderly (PASE)), physical fitness (30s arm curl, 30s chair stand, 6 min walk), cognition (Trail-Making-Test (TMT)), falls status, and quality of life (SF36). Factor analyses suggested a 1-factor solution for the ABC-D6 scale (explained varian...
Development and initial validation of the Falls Efficacy Scale-International (FES-I)
Age and Ageing, 2005
Background: there is a need for a measure of fear of falling that assesses both easy and difficult physical activities and social activities and is suitable for use in a range of languages and cultural contexts, permitting direct comparison between studies and populations in different countries and settings. Objective: to develop a modified version of the Falls Efficacy Scale to satisfy this need, and to establish its psychometric properties, reliability, and concurrent validity (i.e. that it demonstrates the expected relationship with age, falls history and falls risk factors). Design: cross-sectional survey. Setting: community sample. Method: 704 people aged between 60 and 95 years completed The Falls Efficacy Scale-International (FES-I) either in postal self-completion format or by structured interview. Results: the FES-I had excellent internal and test-retest reliability (Cronbach's α=0.96, ICC=0.96). Factor analysis suggested a unitary underlying factor, with two dimensions assessing concern about less demanding physical activities mainly in the home, and concern about more demanding physical activities mainly outside the home. The FES-I had slightly better power than the original FES items to discriminate differences in concern about falling between groups differentiated by sex, age, occupation, falls in the past year, and falls risk factors (chronic illness, taking multiple or psychoactive medications, dizziness). Conclusions: the FES-I has close continuity with the best existing measure of fear of falling, excellent psychometric properties, and assesses concerns relating to basic and more demanding activities, both physical and social. Further research is required to confirm cross-cultural and predictive validity.
Journal of Aging and Health, 2014
Objectives: To describe change in balance confidence, and to identify associated factors and disabling consequences. Method: Secondary analysis of 2 years of data collected from 272 older women enrolled in a randomized clinical trial of fall prevention. Balance confidence and disability measures were assessed at baseline, after the 12 week intervention, and at 1 and 2 years follow-up. Associated factors were measured at baseline. Results: Balance confidence varied at baseline and decreased 5% over 2 years, but no variables predicted this decline. Baseline balance confidence was associated with poor physical function and mental health. Decreasing balance confidence was associated with increasing impairments in balance and hip flexion strength, increasing functional limitations in mobility and chair rises, reduced physical activity levels, increased activity restrictions, and decreasing social networks. Discussion: Decreasing balance confidence plays an important role in disablement. ...