Article

Fear of falling is a common concern among adults over age 65, which results in
decreased activity levels. Cognitive-behavioral therapy (CBT) uses psychological
techniques to redirect negative cognitive, emotional, or behavioral affects for
improvement of self-efficacy and reduced fear of falling. The purpose of this
case study is to describe the integration of CBT into the physical therapy (PT)
management of a middle-aged male with fear of falling and difficulty walking. The
single subject was a 58-year-old male with complaints of frequently losing his
balance, feeling unstable while walking, and requiring the use of a walker to
ambulate. During the initial PT examination his primary impairment was difficulty
ambulating in open spaces. Dynamic Gait Index (DGI) was 8/24 and the Modified
Falls Efficacy Score (MFES) was 6.36/10. The interventions began with a general
lower extremity strengthening program, balance exercises, and gait training. At
visit 9, CBT techniques of cognitive restructuring were added. Visualization of
correct gait patterns was added to the program during visit 10, which continued
until discharge after visit 14. Measurements on the DGI improved to 23/24 and
MFES improved to 9.43/10 at discharge. Gait pattern improved with the ability to
ambulate indoors without an assistive device and using only a straight cane for
community ambulation. The use of CBT is well documented as a group intervention
for older adults with fear of falling, but CBT techniques may also be helpful for
younger adults with fear of falling.

Langue : ANGLAIS