An International Aging Research Collaboration During The COVID-19 Crisis: Mitigating Global Health Consequences

There are several reasons for forming an aging international research collaboration; however, creating a successful and productive research team during the global crisis may require extensive planning and efforts. Our team consists of ten scholars from five countries, including Hong Kong, Nepal, Singapore, Thailand, and the United States. To accomplish this initiative, we employ ten simple rules for establishing international research collaborations proposed by R. de Grijs (2015). We aim to examine impacts of the pandemic on physical activity, frailty, falls, depression and social networks in diverse older adults. We collect data by online survey and/or face-to –face survey using questionnaires including fear of the COVID, face mask use, Social Network, Rapid Assessment of Physical Activity, a simple frailty questionnaire, CDC fall risk checklist, short Fall-Efficacy Scale International and Patient Health Questionnaire-9. Topics of discussion included: research progression, lessons learned and barriers to international collaboration during the COVID-19 crisis.

Kinesiophobia, fear of fall, neuropathic pain and navicular drop in rheumatoid arthritis- a correlation study

Background: Rheumatoid arthritis (RA) is one of the most common chronic health conditions and a leading cause of pain; joint damage and disability. Fear of fall and kinesiophobia are associated with activity limitations in RA patients because of pain and stiffness which affects the quality of life. Kinesiophobia and fear of fall are associated with pain. The pathogenics and chronicity of RA can lead to neuropathic pain. Hence the aim of this study was to assess pronation of foot and evaluate if there is any correlation between fear of fall, kinesiophobia and neuropathic pain in patients with rheumatoid arthritis.Methods: Subjects in the age group of 30-50 years were included after passing the EULAR criteria and were assessed for navicular drop by using the navicular drop test. Later they were assessed for fear of fall, kinesiophobia and neuropathic pain using fall efficacy scale, Tampa scale and LANSS questionnaire respectively.Results: Significant co-relation was found between kinesiophobia and fear of fall (p value =0.0046) and there were non-significant co-relations between all other factors.Conclusions: Participants with RA showed significant navicular drop where left subtalar joint was more affected than right. According to the LANSS score subjects showed lower concerns of neuropathic pain. Maximum number of subjects displayed high concerns of kinesiophobia and fear fall which proves the significant association between the factors.

Age-Related Vestibular Dysfunction with Motion Sensitive Vertigo and Risk of Fall in Adults

Background: This ageing is physiological process associated with vestibular dysfunction. The incidence of vestibular problems increases with age and can lead to drops, dropping risk, lack of confidence, pain and depression. Vestibular disorder is commonly characterized by vertigo or body discomfort (look and aggravation of postural stability) (a sense of spinning movement). In older adults with a fall history, peripheral vestibular disorders are among the most frequently known and widespread vestibular dysfunctions. Aim: To associate vestibular dysfunction and motion sensitive vertigo and risk of fall in adults. Methodology: Cross sectional study with convenient non- random sampling. For tests has been applied for screening vestibular dysfunction. If a participant shows 2 tests positive have vestibular dysfunction. SPSS 21 is used for data analysis. Results: Highly significant results between association of age with motion sensitive and age with fall efficacy scale P value is less than 5. Results are also significant between MSQ and FES-1. Conclusion: After conducting this research it has been concluded. That age-related vestibular dysfunction significantly associated with motion sensitive vertigo and risk of fall. As with the age people are more concerned about fall Keywords: vestibular dysfunction, vertigo, risk of fall in adults

CORRELATION OF PHYSICAL ACTIVITY WITH FEAR OF FALL IN PATIENTS WITH TOTAL KNEE REPLACEMENT

An older patient who has had total knee replacement surgery may be afraid about falling. Fear of falling following TKR and its effects on physical activity have received little attention. The purpose of this study was to see if there was a link between physical activity and fear of falling in individuals with TKR. The PASE Scale is used to measure physical activity. The fall efficacy scale is reliable measure for assessing fear of falling. The objective of the current study was to assess physical activity and fear of fall and to find Correlation of physical activity with fear of fall in patients with TKR. This research was conducted in the Physiotherapy OPD, in AVBRH Hospital in Wardha. The results of 60 TKR patients were studied. The PASE scale and the FES were used to measure physical activity and fear of falling, respectively. This study significantly showed that the correlation between PASE and FES was negative which means that there is Fear of Fall among participants who undergone TKR which was associated with decrease in physical activity score. Most of the studies indicated that there is decrease in physical activity in patients with TKR but very few studies indicated fear of fall in the patients. Therefore, the current study is being carried out which could help to reach the conclusion to find whether there is any correlation between physical activity and fear of fall in patients undergone TKR.

The Demographic Characteristics Affecting Fear of Falling Avoidance Behaviors in Older Adults

Purpose: Not only falling but also fear of falling deeply affects people's social participation and quality of life. We aimed to investigate the relationship between demographic characteristics and the fear of falling and consequently the life habits and satisfaction in elderly people.Methods: In a cross-sectional study, a total of 203 people aged over 60 years were recruited in Tehran, and assessed using the Fear of Falling Avoidance Behaviors Questionnaire, Falls Efficacy Scale (FES-1), and Life Habits tests (Life-H). Data were used to measure the prevalence of fear of falling and its correlation with life habits.Results:Correlation coefficient of total score of the questionnaire was directly correlated with Fall efficacy scale (p <0.001, r = 0.94), and inversely correlated with Activity (p = 0.004, r = -0.51), and Satisfaction levels (p = 0 (003, r = -0.53) of Life-Habits questionnaire.There were significant correlations between age and FFABQ scores (r=28%, P<0.001), educational level (p<0.000), and also significant relation between gender and fear of falling (p=0.006). The chi-square test showed a significant relationship between the history of falling with fear of falling (p<0.001).Conclusion: fear of falling severely affects life habits and decreases Iranian older people's social activity and participation. It is strongly affected by demographic characteristics such as gender, age, and education.Trial registration number: IR.USWR.REC.1398.093Date of registration: 4th August 2019

A - 17 Fear of Falling in Older Adults with mTBI

Objective To evaluate the use of an assessment of fear of falling (i.e., Short Fall Efficacy Scale [SFES]) in the evaluation and management of mild traumatic brain injury (mTBI) in older adults. Methods Fifty-two older adults (40% male) aged 60–76 (66.44 ± 4.74) years were included in the study; 27 older adults diagnosed with mTBI within three months of injury (33.07 ± 18.86 days) and 25 age-group and sex-matched controls. All participants completed the SFES, Vestibular/Ocular-Motor Screening (VOMS), Post-Concussion Symptom Scale (PCSS), Generalized Anxiety Disorder- 7 Item (GAD-7), and Geriatric Depression Scale- 5 Item (GDS5). Statistical comparisons were performed using paired t-tests and Pearson correlations. Results There were no significant differences on demographic factors, with the exception of participants in the mTBI group being more likely to have a history of a sleep disorder (χ2 = 10.26, p = 0.001). T-tests revealed higher concern for falling on SFES and higher total symptoms on the VOMS, GAD-7, and PCSS (p &lt; 0.01) in mTBI versus controls. Those with mTBI who sustained a fall, compared to other mechanisms of injury, did not differ in their report of fear of falling post-injury (p = 0.74). SFES scores were moderately correlated with VOMS total score (r = 0.40, p &lt; 0.01), PCSS total score (r = 0.64, p &lt; 0.01), GAD-7 (r = 0.65, p &lt; 0.01), and GDS-5 (r = 0.60, p &lt; 0.05). Conclusions Older adults with mTBI endorse greater fear of falling on the SFES and more symptoms on mTBI assessment tools relative to healthy controls. Future studies should include objective measures of balance to evaluate the relationship between fear of falling and postural stability.

ASSESSMENT OF FALL RISK AMONG ELDERLY IN HOME ENVIRONMENT IN AL-HASA

Introduction and Aim: Fall it is an accident that unintentionally breaks down a person on the floor, the surface of the earth, or any other low level. The goal of this study was to estimate the prevalence of falls among the elderly and investigate the factors that contribute to this study. Method: The study design was quantitative, descriptive that surveyed for elderly risk of fall and their caregivers, using google form. The study was conducted by a two questionnaire type assessment, 8 questions were used to assess each questionnaire, using fall efficacy scale International with four options (not at all concerned, somewhat concerned, fairly concerned, very concerned), and using Modified Barthel index scale with thee options (No, complete dependence, yes, partially assist, and independence). Result: People who are 65 Years old and above were 140 participated in the study. In Barthel index study about (32.9% - 52.1%) was independence, and about (29.3% - 48.6%) were need partial assist, and about (18.6% - 36.4%) were complete dependence. In fall efficacy scale about (6.4% - 42.9%) were not at all concerned, and about (12.9% - 31.4%) were somewhat concerned, and about (12.9% - 29.3%) were fairly concerned, and about (12.9% - 57.1%) were very concerned. Conclusion: The elderly stage is the most stage or period that the human will have many conditions that enhance to fall.

Upper Limb Dysfunction Increases Fear of Falling in People With Stroke

Objective: Our study was planned to investigate the effect of upper limb function on fear of falling in stroke patients. Materials and methods: A total of 61 patients, 33 women with chronic hemiplegia or hemiparesis, were included in the study. Patients’ upper limb motor condition was obtained using the Fugl-Meyer Upper Extremity Rating Scale (FMA), upper limb function Arm Motor Ability Test (AMAT) and fear of falling International Fall Efficacy Scale (FES-I). Standard Mini-Mental Examination scale was used to exclude patients with mental disorders. Results and Discussion: There was a highly significant negative correlation between FES-I and AMAT and FMA scores (p <0.001, r = -0.926 and r = -0.888, respectively). There was also a significant positive correlation between FMA and stroke time (p <0.05). It was observed that the fear of falling with the level of upper limb dysfunction increased in parallel. Conclusion: It suggests situation that this is due to the fact that they experience balance problems as a result of upper limb dysfunction and when they fail to reveal protective reflexes in a quality way Bangladesh Journal of Medical Science Vol.20(3) 2021 p.539-542

Physio-fEedback and Exercise pRogram (PEER) for Shifting Maladaptive Fall Risk Appraisal

We aimed to examine the effectiveness of Physio-feEdback and Exercise pRogram (PEER) for shifting maladaptive to adaptive fall risk appraisal and determine the feedback and acceptability of the program. Forty-one older adults were assigned to either PEER intervention or attention control (AC) group. The 8-week PEER intervention consists of a visual physio-feedback, cognitive reframing, and combined group and home-based exercise led by a trained peer coach. The AC group read fall prevention brochures and continued their normal activities. BTrackS Balance Test and Fall Efficacy Scale were measured from pre- to post-intervention. About 11% of participants in the PEER group had positive shifting but none in AC group. Up to 32% of the participants in AC had negative shifting while 5.3% in the PEER group. PEER intervention facilitates a shift from maladaptive to adaptive fall risk appraisal. PEER group reported significant decreases in fall risk and high acceptability of the program.