Highlights
- •Falls efficacy (FE) represents the confidence in performing daily activities without falling.
- •This study examined FE as a determinant of successful inpatient geriatric rehabilitation.
- •Higher FE predicted better gait speed and functional status at discharge from rehabilitation.
- •Interventions in rehabilitation aimed at enhancing FE may contribute to patient progress.
Abstract
Objective
To examine the relationship between falls efficacy and the change in gait speed and
functional status in older patients undergoing postacute rehabilitation.
Design
Prospective cohort study.
Setting
Postacute rehabilitation facility.
Participants
Patients (N=180) aged 65 years and older (mean age ± SD, 81.3±7.1y).
Interventions
Not applicable.
Main Outcome Measures
Data on demographics; functional, cognitive, and affective status; and falls efficacy
using a 10-item version of the Falls Efficacy Scale (FES; range, 0-100) were collected
upon admission. Data about gait speed and functional status (Barthel Index and Basic
Activities of Daily Living [BADL]) were measured at admission and discharge. In addition,
BADL performance was self-reported 1 month after discharge.
Results
Compared with admission, all rehabilitation outcomes improved at discharge: gait speed
(0.41±0.15 m/s vs 0.50±0.16 m/s; P<.001), Barthel Index score (68.4±16.3 vs 82.5±13.6; P<.001), and BADL (3.5±1.6 vs 4.7±1.3; P<.001). Adjusting for baseline status and other potential confounders, baseline FES
independently predicted gait speed (adjusted coefficient: 0.002; 95% confidence interval
[CI], 0.000-0.004; P=.025) and Barthel index (adjusted coefficient: 0.225; 95% CI, 0.014-0.435; P=.037) at discharge, with higher confidence at baseline predicting greater improvement.
Baseline FES was also independently associated with self-reported BADL performance
at the 1-month follow-up (adjusted coefficient: 0.020; 95% CI, 0.010-0.031; P<.001).
Conclusions
In older patients, higher falls efficacy predicted better gait and functional rehabilitation
outcomes, independently of baseline performance. These results suggest that interventions
aiming at falls efficacy improvement during rehabilitation might also contribute to
enhancing gait speed and functional status in patients admitted to this setting.
Keywords
List of abbreviations:
BADL (Basic Activities of Daily Living), CI (confidence interval), FE (falls efficacy), FES (Falls Efficacy Scale), MMSE (Mini Mental State Examination)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 23, 2021
Footnotes
Supported in part by the Swiss National Scientific Foundation (grant no. 3252BO-100416). The sponsor did not contribute to any part of the study or the preparation of the manuscript.
Disclosures: none.
Identification
Copyright
© 2021 by the American Congress of Rehabilitation Medicine
