Article

Journal of Neural Transmission

, Volume 114, Issue 10, pp 1309-1314

The effects of reducing fear of falling on locomotion in older adults with a higher level gait disorder

  • Y. BalashAffiliated withMovement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical CenterDepartments of Neurology and Physical Therapy, Sackler School of Medicine, Tel-Aviv University
  • , M. Hadar-FrumerAffiliated withDepartments of Neurology and Physical Therapy, Sackler School of Medicine, Tel-Aviv University
  • , T. HermanAffiliated withMovement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical Center
  • , C. PeretzAffiliated withMovement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical CenterDepartments of Neurology and Physical Therapy, Sackler School of Medicine, Tel-Aviv University
  • , N. GiladiAffiliated withMovement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical CenterDepartments of Neurology and Physical Therapy, Sackler School of Medicine, Tel-Aviv University
  • , J. M. HausdorffAffiliated withMovement Disorders Unit, Department of Neurology, Tel-Aviv Sourasky Medical CenterDepartments of Neurology and Physical Therapy, Sackler School of Medicine, Tel-Aviv UniversityDivision on Aging, Harvard Medical School

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Summary

Fear of falling (FOF) is one of the key clinical features affecting older adults with a higher-level gait disorder (HLGD), however, its effect on gait is not clear. Twenty-one HLGD patients walked under four conditions: 1) usual walking, 2) while holding a physical therapist’s hand, 3) while using a walker, and 4) while being guarded. All three interventions reduced FOF, but guarding did not significantly affect any gait parameter (p > 0.10) and the walker only increased gait speed. In contrast, handholding improved gait speed and reduced gait variability, however, an altered gait pattern persisted even with handholding. Interventions such as handholding, guarding or use of a walker apparently may reduce FOF in HLGD patients, but the impact of this reduction on gait is limited. Thus, it appears that the gait disturbances in these patients are apparently not simply the consequence of FOF.

Keywords: Gait; aging; fear; falls