Castro, P;
Vadera, S;
Bancroft, MJ;
Buttell, J;
Kaski, D;
(2021)
Case Report: Acute Onset Fear of Falling and Treatment With "Cognitive Physical Therapy".
Frontiers in Neurology
, 12
, Article 707840. 10.3389/fneur.2021.707840.
Preview |
Text
Bancroft_fneur-12-707840.pdf - Published Version Download (476kB) | Preview |
Abstract
Fear of falling (FoF) is prevalent in older adults, especially those with previous falls, and typically starts insidiously. We present a 78-year-old woman with an abrupt onset FoF and no history of falls, balance problems, vertigo, oscillopsia, psychiatric or psychological issues to account for this. These cognitive changes led to a behavioural alteration of her gait that became slow and wide-based, with her gaze fixed on the floor. She began a tailored program of “Cognitive Physical Therapy (CPT)” combining cognitive behavioural therapy (CBT) and physical rehabilitation. 1 month later her 6 m walk time and steps were reduced by a 25 and 35%, respectively, and the stride length increased by 34%, with further improvement 2 months later. We postulate that the abrupt onset of symptoms triggered a central shift toward postural hypervigilance and anxiety, suppression of anticipatory (feed forward) postural adjustments (APA) leading to FoF. CPT improved objective gait parameters related to FoF and reduced postural anxiety suggesting that early diagnosis and prompt treatment may avoid chronic symptoms and social isolation.
| Type: | Article |
|---|---|
| Title: | Case Report: Acute Onset Fear of Falling and Treatment With "Cognitive Physical Therapy" |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.3389/fneur.2021.707840 |
| Publisher version: | https://doi.org/10.3389/fneur.2021.707840 |
| Language: | English |
| Additional information: | © 2021 Castro, Vadera, Bancroft, Buttell and Kaski. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
| Keywords: | Fear of falling, falls, postural anxiety, cognitive behavioural therapy, cognitive physical therapy |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Life Sciences > Div of Biosciences |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10134492 |
Archive Staff Only
 |
View Item |
