THE CLINICAL CHARACTERISTICS OF SAUDI MEN AND WOMEN LIVING WITH A STROKE: INFLUENCE OF GENDER AND FALL SELF-EFFICACY

R. Almajid¹, N. Alharbi², Z. Sharahili³, D. Alqahtani³, M.L. Galantino⁴

¹Stockton University, Physical Therapy, Galloway, United States, ²Prince Sultan Military Medical City, Riyadh, Saudi Arabia, ³King Fahad Medical Military Complex, Dhahran, Saudi Arabia, ⁴Stockton University, Galloway, United States

Background: Up to 66% of stroke survivors develop a fear of falling (FOF), which has profound detrimental effects on the quality of life. Gendered pattern influences the FOF; women are more fearful of fall than men, and cross-cultural differences impact health behaviors. It is documented that Saudi Arabia has a high prevalence of physical inactivity, particularly among women. Despite the high prevalence of FOF in stroke survivors, studies that explore this issue across different cultures and gender are lacking.

Purpose:Purpose: We explored the factors that increase the FOF, as measured by the Fall Self-Efficacy scale (FES), in men and women who survive a stroke in Saudi Arabia.

Methods: 24 women (age 63.1 ±7.5) and 22 men (age 61.0 ±9.1) participated in this study. FOF was measured using the FES. The motor function was captured by the five-times sit-to-stand test (5TSTS), Berg Balance Scale (BBS), Timed Up and Go test (TUG), and 6-minute walk test (6MWT). The cognitive status was assessed using Montreal Cognitive Assessment (MOCA), and balance confidence was measured using the Activity-Specific Balance Confidence (ABC) scale. Lastly, the affective function was assessed using Pittsburgh Sleep Quality Index (PSQI), Beck Depression Index (BDI), and Fatigue Severity Scale (FSS). Personal characteristics included age, education, and gender, and the number of medications was recorded. The correlation between fear of falling and motor, cognitive, and affective characteristics was calculated using Spearman rho (p<0.05).

Results: Women with more FOF have significantly poorer motor performance as measured by 6MWT (r_s=-.56, p=0.004), 5TSTS (r_s=0.6, p<0.001), BBS (r_s=-.76, p<0.001), TUG (r_s=0.67, p<0.001), balance confidence and cognitive performance as measured by ABC (r_s=-.8, p<0.001) and MoCA (r_s=-.45, p=0.027). Men with more FOF have significantly less balance confidence (r_s=-0.7, p<0.001) and are more depressed (r_s=0.7, p<0.001) and fatigued (r_s=0.6, p=0.007).

Conclusions: Our preliminary data show that FOF is significantly associated with balance confidence after stroke. However, FOF is multifactorial and includes different factors in Saudi men and women who survived a stroke.

Implications: FOF may impact engagement in rehabilitation protocols and translate into poorer motor performance in the clinical outcome measures, especially in women. Rehabilitation protocols that address falls among stroke survivors should take into account motor and cognitive functions in women and the affective function in men.

Funding acknowledgements: None to report

Keywords:
Falls
Fear of falling
Fall Self-efficacy

Topics:
Neurology: stroke
Disability & rehabilitation
Older people

Did this work require ethics approval? Yes

Institution: Prince Sultan Medical Military City

Committee: Prince Sultan Medical Military City

Ethics number: 1584