TY  - JOUR
PY  - 2018//
TI  - Decreasing fear of falling in chronic stroke survivors through cognitive behavior therapy and task-oriented training
JO  - Stroke
A1  - Liu, Tai-Wa
A1  - Ng, Gabriel Y. F.
A1  - Chung, Raymond C. K.
A1  - Ng, Shamay S. M.
SP  - STROKEAHA118022406
EP  - STROKEAHA118022406
VL  - ePub
IS  - ePub
N2  - 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>
LA  - en
SN  - 0039-2499
UR  - http://dx.doi.org/10.1161/STROKEAHA.118.022406
ID  - ref1
ER  -