Interrelationship Among Fear of Falling, Gait Characteristics and Dynamic Balance in Stroke Survivors – A Case-control Study

Abstract

Objective: The influence of gait characteristics (GCs) and dynamic balance (DB) on fear of falling (FoF) among stroke survivors (SSs) remains unclear. This casecontrol study compared and correlated FoF, GC, and DB among SSs and apparently healthy controls (AHCs). Materials and Methods: A total of 55 ambulant SSs and 110 age–sex-matched AHCs were recruited from two Nigerian hospitals. The FoF, GC (gait speed, cadence, stride length, and step length), and DB were assessed using the fall efficacy scale-international, accelerometer (BTS-G walk) and time-up and go test, respectively. Pearson's product-moment correlation coefficient and an independent t-test were applied. The alpha level was set at P < 0.05. Results: The majority of SSs (87%) had a high risk of falling while AHCs (94.5%) had a low risk of falling. Additionally, 23.6% of SSs and 17.3% of AHCs had had a fall 12 months preceding the study. The SSs had significantly lower gait speeds (0.8 +- 0.3 m/s vs. 1.2 +- 0.3 m/s; t: -8.286; P < 0.001), cadence (80.5 +- 25.3 steps/min vs. 110.1 +- 11.3 steps/min; t: -10.399; P < 0.001), and DB (26.9 +- 18.1 s vs. 9.0 +- 2.4 s; t: 10.240; P < 0.001) than AHCs. The FoF was negatively correlated with cadence (r: -0.340; P = 0.011) and gait speed (r: -0.383; P = 0.004), and positively correlated with DB (r: 0.700; P < 0.001), while gait speed was negatively correlated with DB (r: -0.645; P < 0.001) among SSs. A similar pattern of correlations was observed among AHCs. Conclusion: SSs demonstrated a high FoF, poor DB with an increased risk of falling, and altered GC compared with AHCs. In addition, significant relationships were found among FoF, DB, and GC among SSs and AHCs.

Keywords

• stroke
• fall
• walking
• postural control
• older adults