Fear of Falling Clinical Trial
Official title:
Exposure Therapy for Fear of Falling in Older Adults
This project aims to test the efficacy of an in-home intervention, "Activity, Balance, Learning, and Exposure" (ABLE), which integrates exposure therapy with cognitive restructuring, exercise, and home safety evaluation for older adults with excessive fear of falling. The intervention will be conducted by a licensed physical therapist. A control intervention will be conducted by a health educator. The specific aims of the study are to test the feasibility, acceptability, tolerability, and safety of the ABLE intervention.
Approximately 7-14% of older adults living independently in the community, including more
than 5% of those who have never experienced a fall, experience moderate to severe fear of
falling. Fear of falling leads to decreased physical activity, disability, loss of
independence, depression, anxiety, reduced social engagement, and poor quality of life. It
is also a major independent risk factor for falls.
Interventions targeting fear of falling, typically delivered in groups and incorporating
cognitive restructuring, education, and exercise, have been shown to increase fall-related
self-efficacy. Avoidance is resistant to treatment, however, and more than one-third of
patients enrolled in these interventions drop out. Factors associated with attrition include
high levels of fear and avoidance, indicating that the individuals most in need of such
programs are those most likely to withdraw prematurely. These data suggest that avoidance
should be targeted in treatment, and that interventions should be designed to reach very
fearful individuals who are most likely to drop out of traditional fear of falling programs.
Participation in this study will last up to 8 months. Participants will be randomly assigned
to receive either the ABLE intervention or an education control condition. The control
condition will consist of in-person education about falls to control for the time and
attention provided in the ABLE arm.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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