ABSTRACT

This study was designed to evaluate the clinical utility of the Fall Efficacy Scale (FES) for the prediction of falls in stroke patients. We demonstrated whether the FES can measure the standards for the screening of risk factors for falling by stroke patients. In addition, we identified the factors the affect the FES and the predictive factors of falling. Methods : The subjects included 69 inpatients with hemiparesis who can walk independently. We surveyed the number of falls and used the FES to identify their fear of falling. and conducted an evaluation on their cognitive function and depression using the Mini Mental State Examination, Korean version (MMSE-K) and Geriatric Depression Scale, Korean version (GDS-K). The assessments on their functional performance measured their activities of daily living (Modified Barthel Index; MBI), strength of their lower limbs (Sit to Stand Test; SIT), limb paresis (Fugl-Meyer Upper/Lower Extremity; FM-U/E, L/E), balance (Berg Balance Scale; BBS), and mobility (Timed Up & Go test; TUG). A receiver operation characteristic curve was utilized to investigate the optimum cutoff value of the FES on the prediction of falling, and a multiple linear regression analysis and logistic regression analysis were used to identify the main factors for FES and the prediction of falling. Results : A cut-off score of ≥14.5 on the FES was the standard value for the prediction of risk factors of falling, and <14.5 was used for those with a low incidence of falling. The most affective factors of FES were the TUG variables, and we identified that FES as a psychologic factor exists in terms of a discrimination between the falling group and non-falling group. Conclusion : FES is able to assess the self-efficacy related the fear of falling, and identify the functional performance ability. In addition, FES may be used as part of an initial assessment tool to identify the related falling risk. To comprehensively understand the related risk of falling in individual patients, further study is needed, including a quantitative analysis evaluating the patient's physical function, and should include psychologic factors.