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Agneta Stahle - One of the best experts on this subject based on the ideXlab platform.
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assessing the relative and absolute reliability of the Falls Efficacy Scale international questionnaire in elderly individuals with increased fall risk and the questionnaire s convergent validity in elderly women with osteoporosis
Osteoporosis International, 2013Co-Authors: Alexandra Halvarsson, Erika Franzen, Agneta StahleAbstract:Summary The Falls Efficacy Scale-International (FES-I) is a highly reliable questionnaire for assessing fear of falling in elderly individuals with increased fall risk and has low or no convergent validity with balance performance tests and health-related quality of life (HRQL) among elderly women with osteoporosis, which indicates that both measurements should be included as they are measuring different components.
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effects of new individually adjusted progressive balance group training for elderly people with fear of falling and tend to fall a randomized controlled trial
Clinical Rehabilitation, 2011Co-Authors: Alexandra Halvarsson, Elisabeth Olsson, Elin Faren, Anna F Pettersson, Agneta StahleAbstract:Objective: To evaluate the effects of a new, individually adjusted, progressive and specific balance group training programme on fear of falling, step execution, and gait in healthy elderly people with fear of falling and tend to fall.Design: Randomized controlled trial.Setting: The study was conducted in Stockholm County, Sweden.Subjects: Fifty-nine community dwelling elderly people were recruited by advertisement, and allocated at random to an intervention group (n = 38) or a control group (n = 21).Intervention: Individually adjusted, progressive and specific balance group training was given three times a week for three months. The training incorporated elements included in, and required for, independent activities of daily living, and for reactions to loss of balance during dual or multiple tasks.Main measures: Fear of falling was assessed with Falls Efficacy Scale International (FES-I). The reaction time of step execution was measured with the step-execution test, and gait was measured with GAITRite®....
Chris Todd - One of the best experts on this subject based on the ideXlab platform.
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validity and sensitivity to change of the Falls Efficacy Scales international to assess fear of falling in older adults with and without cognitive impairment
Gerontology, 2010Co-Authors: Klaus Hauer, Lucy Yardley, Nina Beyer, Gertrudis I J M Kempen, Chris Todd, Michael Schwenk, P Oster, G Rixt A ZijlstraAbstract:Background: Measures of fear of falling have not yet been validated in patients with dementia, leaving a methodological gap that limits research in a population at high risk of falling and fall-related consequences. Objective: The objectives of this study are to determine: (1) the validity of the 7-item Short Falls Efficacy Scale International (Short FES-I) in geriatric patients with and without cognitive impairment, and (2) the sensitivity to change of the 10-item Falls Efficacy Scale (FES), the 16-item FES-I and the 7-item Short FES-I in geriatric patients with dementia. Methods: Cross-sectional data of community-dwelling older adults and geriatric rehabilitation patients (n = 284) collected during face-to-face interviews were used to determine construct and discriminant validity by testing for differences within variables related to fear of falling. Sensitivity to change was studied in an intervention study including patients with mild to moderate dementia (n = 130) as determined by standard response means (SRMs). Results: The Short FES-I showed excellent construct and discriminant validity in the total group and subsamples according to cognitive status. Sensitivity to change was adequate to good in the FES (range SRM: 0.18–0.77) and FES-I (range SRM: 0.21–0.74), with the Short FES-I showing the highest peak sensitivity to change (range SRM: 0.18–0.91). Conclusions: The Short FES-I is a valid measure to assess fear of falling in frail older adults with and without cognitive impairment, yet it may show floor effects in higher functioning older people. All Scales, including the Short FES-I, were sensitive to detecting intervention-induced changes in concerns about falling in geriatric patients with dementia.
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the short fes i a shortened version of the Falls Efficacy Scale international to assess fear of falling
Age and Ageing, 2007Co-Authors: Gertrudis I J M Kempen, Klaus Hauer, Lucy Yardley, Nina Beyer, Jolanda C M Van Haastregt, G Rixt A Zijlstra, Chris ToddAbstract:BACKGROUND: the 16-item Falls Efficacy Scale-International (FES-I) has been shown to have excellent reliability and construct validity. However, for practical and clinical purposes, a shortened version of the FES-I would be useful. OBJECTIVE: to develop and validate a shortened version of FES-I while preserving good psychometric properties. DESIGN: initial development of a shortened version using data from a UK survey (Short FES-I; n = 704), test of reliability and validity of the Short FES-I using data from a Dutch survey (n = 300). SETTING: community samples. METHODS: comparison of reliability and validity of the Short FES-I and the FES-I in a random sample of 193 people aged between 70 and 92. RESULTS: the internal and 4-week test-retest reliability of the Short FES-I is excellent (Cronbach's alpha 0.92, intra-class coefficient 0.83) and comparable to the FES-I. The correlation between the Short FES-I and the FES-I is 0.97. Patterns in differences with respect to mean scores according to age, sex, Falls history, and overall fear of falling are similar for the Short FES-I and the FES-I. The FES-I had slightly better power to discriminate between groups differentiated by age, sex, Falls history, and fear falling, but differences are small. CONCLUSIONS: the Short FES-I is a good and feasible measure to assess fear of falling in older persons. However, if researchers or clinicians are particularly interested in the distributions of specific fear of falling-related activities not included in the Short FES-I, the use of the full FES-I is recommended.
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development and initial validation of the Falls Efficacy Scale international fes i
Age and Ageing, 2005Co-Authors: Lucy Yardley, Klaus Hauer, Nina Beyer, Gertrudis I J M Kempen, C Piotziegler, Chris ToddAbstract: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' 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. © The Author 2005. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
Anat Achiron - One of the best experts on this subject based on the ideXlab platform.
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the relationship between fear of falling to spatiotemporal gait parameters measured by an instrumented treadmill in people with multiple sclerosis
Gait & Posture, 2014Co-Authors: Alon Kalron, Anat AchironAbstract:Abstract People with multiple sclerosis (MS) identify mobility limitations as one of the greatest challenges of this disease. Continued loss of mobility and Falls are among their greatest concerns for the future. Our objective was to determine if fear of falling is associated with spatial and temporal gait parameters in persons with MS, when measured by an instrumented treadmill. This observational case control study was performed at the MS Center, Center of Advanced Technologies in Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel. Sixty-eight relapsing-remitting patients diagnosed with MS, 38 women, aged 40.9 (S.D. = 11.9), participated in this investigation. Twenty-five healthy subjects, 14 women, aged 39.5 (S.D. = 9.4) served as controls gait controls. Gait spatiotemporal parameters were obtained using the Zebris FDM-T Treadmill (Zebris® Medical GmbH, Germany). The Falls Efficacy Scale International was used to assess the level of concern relating to Falls. Forty-one people with MS were classified as highly fearful of falling. Twenty-seven patients were slightly concerned. Highly fearful of falling patients walked slower had a shorter step length, a wider base of support and prolonged double support phase compared to slightly concerned patients. Fearful patients also demonstrated elevated variability of the center of pressure (CoP) trajectory compared to slightly concerned MS patients. Fear of falling and spatiotemporal gait alterations in people with MS are linked. Additionally, variability of the CoP during walking appears to be connected with the level of concern.
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postural control Falls and fear of falling in people with multiple sclerosis without mobility aids
Journal of the Neurological Sciences, 2013Co-Authors: Alon Kalron, Anat AchironAbstract:Abstract The purpose of the study was to determine the relationship between static postural control parameters to fear of falling and falling history in people with multiple sclerosis (MS) without mobility assistive devices. One-hundred and seven relapsing–remitting patients diagnosed with MS, 62 women aged 42.8 (S.D.=12.0), participated in this investigation. Participants were divided into groups based on fall history; 47 had no history during the past 6months and 60 had a history of at least one fall within the same period. Static postural control parameters were obtained from the Zebris FDM-T Treadmill (zebris® Medical GmbH, Germany). The patient's self-reported questionnaire, the Falls Efficacy Scale International (FES-I), was used to assess the level of concern relating to Falls. People with MS classified as fallers exhibited increased center of pressure (CoP) path length, sway velocity and greater overall sway area. CoP path length performed with eyes open was found to explain 42% of the variance related to at least one fall during the past six months; R 2 =0.424, χ 2 (1) =40.727, P P
Klaus Hauer - One of the best experts on this subject based on the ideXlab platform.
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validity and sensitivity to change of the Falls Efficacy Scales international to assess fear of falling in older adults with and without cognitive impairment
Gerontology, 2010Co-Authors: Klaus Hauer, Lucy Yardley, Nina Beyer, Gertrudis I J M Kempen, Chris Todd, Michael Schwenk, P Oster, G Rixt A ZijlstraAbstract:Background: Measures of fear of falling have not yet been validated in patients with dementia, leaving a methodological gap that limits research in a population at high risk of falling and fall-related consequences. Objective: The objectives of this study are to determine: (1) the validity of the 7-item Short Falls Efficacy Scale International (Short FES-I) in geriatric patients with and without cognitive impairment, and (2) the sensitivity to change of the 10-item Falls Efficacy Scale (FES), the 16-item FES-I and the 7-item Short FES-I in geriatric patients with dementia. Methods: Cross-sectional data of community-dwelling older adults and geriatric rehabilitation patients (n = 284) collected during face-to-face interviews were used to determine construct and discriminant validity by testing for differences within variables related to fear of falling. Sensitivity to change was studied in an intervention study including patients with mild to moderate dementia (n = 130) as determined by standard response means (SRMs). Results: The Short FES-I showed excellent construct and discriminant validity in the total group and subsamples according to cognitive status. Sensitivity to change was adequate to good in the FES (range SRM: 0.18–0.77) and FES-I (range SRM: 0.21–0.74), with the Short FES-I showing the highest peak sensitivity to change (range SRM: 0.18–0.91). Conclusions: The Short FES-I is a valid measure to assess fear of falling in frail older adults with and without cognitive impairment, yet it may show floor effects in higher functioning older people. All Scales, including the Short FES-I, were sensitive to detecting intervention-induced changes in concerns about falling in geriatric patients with dementia.
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the short fes i a shortened version of the Falls Efficacy Scale international to assess fear of falling
Age and Ageing, 2007Co-Authors: Gertrudis I J M Kempen, Klaus Hauer, Lucy Yardley, Nina Beyer, Jolanda C M Van Haastregt, G Rixt A Zijlstra, Chris ToddAbstract:BACKGROUND: the 16-item Falls Efficacy Scale-International (FES-I) has been shown to have excellent reliability and construct validity. However, for practical and clinical purposes, a shortened version of the FES-I would be useful. OBJECTIVE: to develop and validate a shortened version of FES-I while preserving good psychometric properties. DESIGN: initial development of a shortened version using data from a UK survey (Short FES-I; n = 704), test of reliability and validity of the Short FES-I using data from a Dutch survey (n = 300). SETTING: community samples. METHODS: comparison of reliability and validity of the Short FES-I and the FES-I in a random sample of 193 people aged between 70 and 92. RESULTS: the internal and 4-week test-retest reliability of the Short FES-I is excellent (Cronbach's alpha 0.92, intra-class coefficient 0.83) and comparable to the FES-I. The correlation between the Short FES-I and the FES-I is 0.97. Patterns in differences with respect to mean scores according to age, sex, Falls history, and overall fear of falling are similar for the Short FES-I and the FES-I. The FES-I had slightly better power to discriminate between groups differentiated by age, sex, Falls history, and fear falling, but differences are small. CONCLUSIONS: the Short FES-I is a good and feasible measure to assess fear of falling in older persons. However, if researchers or clinicians are particularly interested in the distributions of specific fear of falling-related activities not included in the Short FES-I, the use of the full FES-I is recommended.
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development and initial validation of the Falls Efficacy Scale international fes i
Age and Ageing, 2005Co-Authors: Lucy Yardley, Klaus Hauer, Nina Beyer, Gertrudis I J M Kempen, C Piotziegler, Chris ToddAbstract: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' 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. © The Author 2005. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved.
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measuring the psychological outcomes of falling a systematic review
Journal of the American Geriatrics Society, 2005Co-Authors: Ellen C Jorstad, Klaus Hauer, Clemens Becker, Sarah E LambAbstract:The objectives were to identify fall-related psychological outcome measures and to undertake a systematic quality assessment of their key measurement properties. A Cochrane review of fall-prevention interventions in older adults was used to identify fall-related psychological measurements. PubMed, CINAHL, and PsycINFO were systematically searched to identify instruments not used in trials and papers reporting the methodological quality of relevant measures. Reference lists of articles were searched for additional literature, and researchers were contacted. Two reviewers undertook quality extraction relating to content, population, reliability, validity, responsiveness, practicality, and feasibility. Twenty-five relevant papers were identified. Twenty-three measures met the inclusion criteria: six single-item questions, Falls Efficacy Scale (FES), revised FES, modified FES, FES-UK, Activities-specific Balance and Confidence Scale (ABC), ABC-UK, Confidence in maintaining Balance Scale, Mobility Efficacy Scale, adapted FES, amended FES, Survey of Activities and Fear of Falling in the Elderly (SAFFE), University of Illinois at Chicago Fear of Falling Measure, Concern about Falling Scale, Falls Handicap Inventory, modified SAFFE, Consequences of Falling Scale, and Concern about the Consequences of Falling Scale. There is limited evidence about the measurement properties of single-item measures. Several multiitem measures obtained acceptable reliability and validity, but there is less evidence regarding responsiveness, practicality, and feasibility. Researchers should select measures based on the constructs they intend to study. Further research is needed to establish and compare the instruments' measurement properties.
Shihching Chen - One of the best experts on this subject based on the ideXlab platform.
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effects of interactive video game based system exercise on the balance of the elderly
Gait & Posture, 2013Co-Authors: Chien Hung Lai, Chih Wei Peng, Yuluen Chen, Chingping Huang, Yuling Hsiao, Shihching ChenAbstract:Abstract This study evaluated the effects of interactive video-game based (IVGB) training on the balance of older adults. The participants of the study included 30 community-living persons over the age of 65. The participants were divided into 2 groups. Group A underwent IVGB training for 6 weeks and received no intervention in the following 6 weeks. Group B received no intervention during the first 6 weeks and then participated in training in the following 6 weeks. After IVGB intervention, both groups showed improved balance based on the results from the following tests: the Berg Balance Scale (BBS), Modified Falls Efficacy Scale (MFES), Timed Up and Go (TUG) test, and the Sway Velocity (SV) test (assessing bipedal stance center pressure with eyes open and closed). Results from the Sway Area (SA) test (assessing bipedal stance center pressure with eyes open and closed) revealed a significant improvement in Group B after IVGB training. Group A retained some training effects after 6 weeks without IVGB intervention. Additionally, a moderate association emerged between the Xavix measured step system stepping tests and BBS, MFES, Unipedal Stance test, and TUG test measurements. In conclusion, IVGB training improves balance after 6 weeks of implementation, and the beneficial effects partially remain after training is complete. Further investigation is required to determine if this training is superior to traditional physical therapy.