Study Says a Cognitive Intervention for Fear of Falling Gets Same Results as ‘Usual’ Care

A new study released in JAMDA says at least one type of cognitive behavioral intervention to help elders with a fear of falling after a hip fracture may not work any better than “usual” care in reducing such anxiety.

The report said a fear of falling is common after a hip fracture and can impede functional recovery. But, despite advances in acute care and post-acute rehabilitation services provided for patients with hip fractures, long-term functional recovery after this event remains limited.

In the study, “Effects of the FIT-HIP Intervention for Fear of Falling after Hip Fracture: A Cluster Randomized Controlled Trial in Geriatric Rehabilitation,” researchers assessed the benefit of the FIT-HIP intervention, a multi-component, cognitive behavioral intervention for geriatric rehabilitation.

They compared this intervention to usual care in this setting for patients recovering from a hip fracture. “The FIT-HIP intervention consists of cognitive behavioral elements aimed at reducing fear of falling, including psychoeducation, guided exposure to feared activities, cognitive restructuring, and relapse prevention,” the study said. “Usual care includes mobility training, efforts to improve balance and gait, and exercise to boost muscle strength.”

The result of this comparison between cognitive and usual care was no significant differences between groups observed for primary outcome measures, specifically, a change in fear of falling and/or mobility function.

“Results of this study demonstrate that management of fear of falling after recent hip fracture remains challenging. … We recommend that further research first focuses on exploring the ‘time-mediated effect’ of fear of falling after hip fracture, thereby gaining insight into how the direct physical consequences of hip fracture influence and relate to fear of falling,” the researchers said.

The study was conducted by researchers in the Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands; Department of Health Services Research and Care, Public Health Research Institute, and Department of Family Medicine and Care, Maastricht University, Maastricht, the Netherlands; and Department of Medical Statistics and Bioinformatics, Leiden University Medical Center, Leiden, the Netherlands.

JAMDA is the official journal of AMDA – The Society for Post-Acute and Long-Term Care Medicine.