@article{ref1,
title="Decreasing fear of falling in chronic stroke survivors through cognitive behavior therapy and task-oriented training",
journal="Stroke",
year="2018",
author="Liu, Tai-Wa and Ng, Gabriel Y. F. and Chung, Raymond C. K. and Ng, Shamay S. M.",
volume="ePub",
number="ePub",
pages="STROKEAHA118022406-STROKEAHA118022406",
abstract="Background and Purpose- Research has shown that balance training is effective for reducing the fear of falling in individuals with a history of stroke. In this study, we evaluated (1) whether cognitive behavior therapy could augment the beneficial effects of task-oriented balance training (TOBT) in reducing the fear of falling in chronic stroke survivors and (2) whether it could, in turn, reduce fear-avoidance behavior and improve related health outcomes. <br><br>METHODS- Eighty-nine cognitively intact subjects with mildly impaired balance ability were randomized into the following 2 groups that underwent 90-minutes interventions 2 days per week for 8 weeks: (1) cognitive behavior therapy + TOBT or (2) general health education + TOBT (control). The primary outcome was the fear of falling, and the secondary outcomes were fear-avoidance behavior, balance, fall risk, independent daily living, community integration, and health-related quality of life. The outcomes were assessed at baseline, after 4 and 8 weeks of intervention, and 3 and 12 months after completing the intervention. <br><br>RESULTS- Eighty-two subjects completed the intervention and follow-up assessments. From postintervention to 12 months after completing the intervention, the cognitive behavior therapy + TOBT participants reported greater reduction in the fear of falling and fear-avoidance behavior and greater improvements in balance and independent daily living than the general health education + TOBT participants. <br><br>CONCLUSIONS- Cognitive behavior therapy should be considered as an adjuvant therapy to standard physiotherapy for cognitively intact individuals with a history of stroke. Clinical Trial Registration- URL: http://clinicaltrials.gov. Unique identifier: NCT02937532.<p /> <p>Language: en</p>",
language="en",
issn="0039-2499",
doi="10.1161/STROKEAHA.118.022406",
url="http://dx.doi.org/10.1161/STROKEAHA.118.022406"
}