Management of fear of falling after hip fracture

Scheffers-Barnhoorn, M.N. (2023)

Doctoral Thesis

Fear of falling (FoF) after hip fracture is highly prevalent, and has been associated with diminished functional recovery. A treatment program for FoF after hip fracture was developed, for the inpatient geriatric rehabilitation setting (the FIT-HIP intervention, a multi-component cognitive behavioral intervention).
The first studies of this thesis evaluated the effects and feasibility of the FIT-HIP intervention. Also, coping strategies used by patients with FoF were explored. The final study in this thesis evaluated the long-term course of FoF after fracture.
The FIT-HIP intervention was not effective to reduce FoF and improve functional recovery after hip fracture. The (early) timing of the intervention, and a limited level of FoF may have contributed to the lack of treatment effect. Possibly not all FoF that is present very shortly after hip fracture (<6 weeks) is dysfunctional. However, approximately a quarter of all patients with hip fracture have FoF that persists up to 12 weeks (and often hereafter). This group has high levels of FoF, and may thus be prone to the negative effects of FoF (maladaptive FoF). An appropriate selection of the target group remains a challenge. This thesis provides recommendations for the management of FoF, including suggestions for the selection procedure.

• Geriatric Rehabilitation
• Hip fracture
• Fear of falling
• Cognitive behavioral therapy

• All authors: Scheffers-Barnhoorn, M.N.
• Supervisor: Achterberg, W.P.
• Co-supervisor: Eijk, M. van; Haastregt, J.C.M. van
• Committee: Gordon, A.; Gussekloo, J.; Maier, A.M.; Dam van Isselt, E.F. van
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2023-02-02
• ISBN (print): 9789463617871
• Sponsorship: ZonMw, research grant number 839120004; SBOH (employer of elderly care medicine trainees)