درمان و تمرین در معرض یکپارچه کاهش ترس از افتادن و اجتناب از بزرگسالان سالمند: یک مطالعه خلبان تصادفی

Objective: To evaluate the safety and acceptability of a novel 8-week intervention integrating exercise, exposure therapy, cognitive restructuring, and a home safety evaluation, conducted by a physical therapist, in reducing fear of falling and activity avoidance. To collect preliminary evidence of efficacy. Design: Randomized pilot study comparing the intervention to time- and attention-equivalent fall prevention education. Setting: Participants' homes. Participants: 42 older adults with disproportionate fear of falling (high fear, low to moderate objective fall risk). Measurements: Falls Efficacy Scale-International, modified Activity Card Sort, satisfaction, falls. Results: Relative to education, the intervention reduced fear of falling (d = 1.23) and activity avoidance (d = 1.02) at 8 weeks, but effects eroded over a six-month follow-up period. The intervention did not increase falls, and participants rated the exercise, exposure therapy, and non-specific elements as most helpful. Conclusion: An integration of exercise and exposure therapy may help older adults with disproportionate fear of falling, but modifications to the intervention or its duration may be needed to maintain participants' gains.