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Longitudinal Trajectories and Determinants of Fear of Falling in Post-Stroke Patients
Xiaomeng Han1, Mingming Zhong2,3, Wenxiu Niu1,3
1Department of Critical Care Medicine, The First Hospital of Lanzhou University, Lanzhou, China.
Objective:
Fear of falling is a common and serious psychological challenge after stroke, yet its longitudinal patterns remain poorly understood. Current evidence often fails to capture individual heterogeneity in recovery trajectories. This study aimed to identify distinct longitudinal trajectories of fear of falling and explore associated factors to inform targeted rehabilitation strategies in post-stroke patients.
Design:
A prospective longitudinal study.
Methods:
From August 2023 to December 2024, we enrolled 166 stroke patients from the neurology wards of two hospitals in Lanzhou, China, forming a hospital-based sample within an urban healthcare setting. Fear of falling was assessed using a single-item question and the Short Falls Efficacy Scale-International at four time points: 2 weeks, 1 month, 3 months, and 6 months post-stroke. Data were analyzed using latent class growth modeling in Mplus 8.0.
Results:
The prevalence of fear of falling was 48.8%, 49.4%, 45.8%, and 34.3% at 2 weeks, 1 month, 3 months, and 6 months, respectively. Mean Short Falls Efficacy Scale-International scores were 11.30 (±4.74), 9.84 (±3.40), 9.61 (±3.13), and 8.00 (±1.22) at these time points. Three distinct fear of falling trajectories were identified: high-level continuous decline (20.48%), medium-level steady decline (26.51%), and low-level fear (53.01%). Age, anxiety levels, and depression levels were significant factors associated with these trajectories.
Conclusion:
Fear of falling after stroke demonstrates heterogeneous longitudinal trajectories that are significantly influenced by age, anxiety, and depression. These findings highlight the importance of individualized assessment and targeted psychological support during stroke rehabilitation.
Clinical Relevance:
Fear of falling is a dynamic psychological challenge during stroke recovery. Routine screening for fear of falling, anxiety, and depression may help nurses identify patients at risk for persistent fear trajectories. Tailored rehabilitation and psychological interventions may improve rehabilitation participation and recovery outcomes.
Patient Or Public Contribution:
No patient or public engagement.
