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Fear Priming: A Method for Examining Postural Strategies Associated With Fear of Falling.

ABSTRACT: Fear of falling influences postural strategies used for balance, and is key in the maintenance of independent living and quality of life as adults age. However, there is a distinct need for methodology that aims to specifically address and prime fear under dynamic conditions, and to better determine the role of fear in movement preparation. This preliminary study investigated how fear priming influences fear of falling in young and older individuals, and assessed how changes in fear of falling map to movement behavior. Young (21.5 ± 1.7 years, n = 10) and older (58.1 ± 2.2 years) participants matched for height, weight, and sex were repeatedly exposed to four different and incrementally challenging laboratory-based slipping perturbations during a self-initiated, goal-directed step and reach task. Both younger and older cohorts showed similar heightened perceptions in fear of falling after fear priming, and changes in peak joint excursions including reduced ankle flexion, and increased lumbar flexion after fear priming. Age-related changes were only evident in total mediolateral center of mass displacement, with younger participants showing greater displacement after fear priming. Despite clear differences in preparatory muscle onsets relative to reach onset seen in older participants, muscle timings or co-contraction indices were not significantly different. Methods utilizing repeated exposure to varying increases of a slip-based postural challenge can successfully prime fear of falling in individuals, regardless of age.

SUBMITTER: Stamenkovic A

PROVIDER: S-EPMC7419599 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Fear Priming: A Method for Examining Postural Strategies Associated With Fear of Falling.

Stamenkovic Alexander A van der Veen Susanne M SM Thomas James S JS

Frontiers in aging neuroscience 20200805

Fear of falling influences postural strategies used for balance, and is key in the maintenance of independent living and quality of life as adults age. However, there is a distinct need for methodology that aims to specifically address and prime fear under dynamic conditions, and to better determine the role of fear in movement preparation. This preliminary study investigated how fear priming influences fear of falling in young and older individuals, and assessed how changes in fear of falling m ...[more]

PMID: 32848714

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Project description:Fear of falling (FoF) was described as a dichotomy, whereby FoF on one hand posed a threat to the sense of security but on the other hand provided protection against harm through increased awareness and cautious behaviour. These findings contribute to a deeper understanding of FoF for women with osteoporosis.IntroductionFear of falling is a major problem for many individuals in society and it increases with age; it is more common among women, especially women with a diagnosis of osteoporosis. It is important to gain a deeper understanding of the concept of fear of falling among women with osteoporosis to be able to devise fall prevention programmes to address fear of falling in the most appropriate way. Therefore, we aimed to explore and describe how older women with osteoporosis and self-reported balance deficits conceptualise their fear of falling METHODS: A qualitative study with individual interviews was carried out, using a semi-structured interview guide. The interviews were recorded, transcribed verbatim, and analysed with inductive qualitative content analysis. The study includes 25 informants, all women with osteoporosis aged 66-85 years.ResultsThe analysis resulted in one overarching theme, "Fear of falling is a protection and danger", and three main themes: "Fear of falling is a sense of unease", "Fear of falling is to be vulnerable", and "Fear of falling is a call for help".ConclusionThe concept of fear of falling was perceived in terms of emotional states as well as cognitive and active strategies and was described in the context of being able to protect oneself in order to stay safe and secure. The concept was described as a dichotomy, whereby fear of falling on the one hand posed a threat to the sense of security but on the other hand provided protection against harm through increased awareness and cautious behaviour. These findings contribute to a deeper understanding of the phenomenon of fear of falling and how it could be seen from both a positive and negative perspective.

Project description:BackgroundPostural instability is an intractable sign of Parkinson's disease, associated with poor disease prognosis, fall risk, and decreased quality of life.Objective1) Characterize verbatim reports of postural instability and associated symptoms (gait disorder, balance, falling, freezing, and posture), 2) compare reports with responses to three pre-specified questions from Part II of the Movement Disorder Society Unified Parkinson Disease Rating Scale (MDS-UPDRS), and 3) examine postural instability symptoms and MDS-UPDRS responses as predictors of future falls.MethodsFox Insight research participants reported their problems attributed to PD in their own words using the Parkinson Disease Patient Reports of Problems (PD-PROP). Natural language processing, clinical curation, and data mining techniques were applied to classify text into problem domains and clinically-curated symptoms. Baseline postural instability symptoms were mapped to MDS-UPDRS questions 2.11-2.13. T-tests and chi-square tests were used to compare postural instability reporters and non-reporters, and Cochran-Armitage trend tests were used to evaluate associations between PD-PROP and MDS-UPDRS responses; survival methods were utilized to evaluate the predictive utility of PD-PROP and MDS-UPDRS responses in time-to-fall analyses.ResultsOf participants within 10 years of PD diagnosis, 9,692 (56.0%) reported postural instability symptoms referable to gait unsteadiness, balance, falling, freezing, or posture at baseline. Postural instability symptoms were significantly associated with patient-reported measures from the MDS-UPDRS questions. Balance problems reported on PD-PROP and MDS-UPDRS 2.11-2.13 measures were predictive of future falls.ConclusionVerbatim-reported problems captured by the PD-PROP and categorized by natural language processing and clinical curation and MDS-UPDRS responses predicted falls. The PD-PROP output was more granular than, and as informative as, the categorical responses.

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Dataset Information

Fear Priming: A Method for Examining Postural Strategies Associated With Fear of Falling.

Publications

Fear Priming: A Method for Examining Postural Strategies Associated With Fear of Falling.

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