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... Show moreFear 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. Show less
FoF is possibly one of the most important factors in patients after hip fracture, with a substantial impact on the final results of the rehabilitation process. Moreover, patients with hip fracture... Show moreFoF is possibly one of the most important factors in patients after hip fracture, with a substantial impact on the final results of the rehabilitation process. Moreover, patients with hip fracture who rehabilitate in a SNF with high rates of comorbidity and complications, may have even worse outcomes as a result of FoF. Unfortunately, the role of FoF in the rehabilitation of these older persons has not yet been investigated. The overall aim of the work in this thesis is to study FoF in vulnerable older people with hip fractures who rehabilitate in a SNF. To gain more insight into FoF in older patients with hip fracture, the following research questions are addressed:. 1. What is the prevalence of FoF in older patients with a hip fracture rehabilitating in a SNF? 2. Which factors are related to FoF in older patients with a hip fracture? 3. What is the course of FoF after a hip fracture? 4. Is the FES-I a suitable instrument to measure FoF after a hip fracture? 5. Which interventions reduce FoF after hip fracture? 6. What is the prevalence and what are the consequences of FoF in other patient groups who rehabilitate in a SNF? Show less
