Acute onset fear of falling and treatment with 'Cognitive Physical Therapy'
Autor: | Castro Abarca, P, Vadera, S, Bancroft, MJ, Butell, J, Kaski, D |
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Rok vydání: | 2021 |
Předmět: |
Science & Technology
CONSEQUENCES Clinical Neurology Neurosciences AVOIDANCE cognitive physical therapy EXERCISE 1103 Clinical Sciences cognitive behavioural therapy DEPRESSION PREVALENCE postural anxiety PEOPLE 1701 Psychology BALANCE falls RISK-FACTORS ANXIETY fear of falling Neurosciences & Neurology OLDER-ADULTS 1109 Neurosciences Life Sciences & Biomedicine |
Popis: | Fear of falling (FoF) is prevalent in older adults, especially those with previous falls, and typically starts insidiously. We present a 78-year-old woman with an abrupt onset FoF and no history of falls, balance problems, vertigo, oscillopsia, psychiatric or psychological issues to account for this. These cognitive changes led to a behavioural alteration of her gait that became slow and wide-based, with her gaze fixed on the floor. She began a tailored program of “Cognitive Physical Therapy (CPT)” combining cognitive behavioural therapy (CBT) and physical rehabilitation. One month later her 6m walk time and steps were reduced by a 25% and 35%, respectively and the stride length increased by 34%, with further improvement 2 months later. We postulate that the abrupt onset of symptoms triggered a central shift towards postural hypervigilance and anxiety, suppression of anticipatory (feed forward) postural adjustments (APA) leading to FoF. CPT improved objective gait parameters related to FoF and reduced postural anxiety suggesting that early diagnosis and prompt treatment may avoid chronic symptoms and social isolation. |
Databáze: | OpenAIRE |
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