Investigation of Factors Associated with Fear of Falling in Home-Dwelling Patients Discharged After Subacute Orthopedic Rehabilitation

Takumi Matsumoto, Nanami Okada, Koki Yasumoto, Satoshi Hakukawa, Kanata Yoshihara, Kohei Toda
Purpose:

This study aimed to identify factors influencing the fear of falling in patients discharged from a subacute rehabilitation hospital to their homes.

Methods:

This study included 83 patients admitted to a rehabilitation hospital for orthopedic conditions and subsequently discharged to their homes. Patients who were unable to return home or had a Functional Independence Measure (FIM) locomotion score of less than 5 at discharge were excluded. One week before discharge, motor function was evaluated using a three-dimensional motion analysis system (MyoMotion, Noraxon Inc.), which included three inertial measurement unit (IMU) sensors for the 10-meter walking test and the Timed Up and Go Test (TUG). In addition, the Berg Balance Scale (BBS), 6-Minute Walk Distance (6MWD), FIM, Mini-Mental State Examination (MMSE), Visual Analog Scale (VAS) for pain, and Skeletal Muscle Mass Index (SMI) were assessed. One month after discharge, the fear of falling was assessed using the Modified Fall Efficacy Scale (MFES), and any falls during this period were recorded. Spearman’s rank correlation coefficient was used to evaluate the association between MFES scores and the measured parameters at discharge. Stepwise multiple regression analysis was performed for variables that showed significant correlations. A p-value of 0.05 was considered statistically significant.

Results:

Among the 83 patients, two patients experienced a fall within one month after discharge. Significant correlations were found between MFES scores and 10-meter walking speed, Motor-FIM, and gait cycle time Coefficient of Variability (CV) (p 0.05). Multiple regression analysis revealed that gait CV was the only significant variable associated with MFES (p 0.05).

Conclusion(s):

Gait CV has previously been highlighted as a key indicator associated with falls in stroke patients and community-dwelling older adults. This study suggests that gait CV may also serve as an important factor in patients undergoing subacute orthopedic rehabilitation.

Implications:

Identifying factors that influence the fear of falling in the home setting could contribute to the development of higher-quality subacute rehabilitation programs focused on improving physical function and movement quality.

Funding acknowledgements:
This study was supported by a research grant from the France Bed Home Care Foundation.
Keywords:
Fall Prevention
Motion Analysis
Home-Dwelling
Primary topic:
Orthopaedics
Second topic:
Health promotion and wellbeing/healthy ageing/physical activity
Third topic:
Disability and rehabilitation
Did this work require ethics approval?:
Yes
Name the institution and ethics committee that approved your work:
The study protocol was approved by the Institutional Review Board (IRB) of Reiwa Rehabilitation Hospital.
Provide the ethics approval number:
24-03
Has any of this material been/due to be published or presented at another national or international conference prior to the World Physiotherapy Congress 2025?:
No

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