Fear of Falling, Balance Disturbances, and Health-Related Quality of Life in Post-Stroke Inpatients: A Preliminary Cross-Sectional Study

TL;DR

This study explores how fear of falling, balance issues, and quality of life are connected in stroke patients during rehabilitation.

Contribution

The study is one of the few to examine the interplay between psychological, functional, and clinical factors in post-stroke inpatients.

Findings

61.5% of post-stroke patients reported high fear of falling.

Strong correlations were found between HRQoL, balance, and fear of falling.

Patients with greater neurological impairment had worse HRQoL and higher fear of falling.

Abstract

Background/Objectives: Fear of falling is highly prevalent after stroke and may interact with mobility limitations, neurological deficits, and reduced quality of life. However, few studies have examined these dimensions together during inpatient rehabilitation. This study aimed to assess fear of falling, balance and gait performance, and HRQoL in adults undergoing post-stroke inpatient rehabilitation, and to examine the interrelationships among psychological, functional, and clinical measures to support multidimensional assessment strategies. Methods: This cross-sectional study included 39 patients (51.28% women, 71.79% after ischemic stroke) undergoing post-stroke inpatient rehabilitation. The main assessments included the Falls Efficacy Scale-International (FES-I), the Tinetti Test (TT), and the Short Form-36 (SF-36). Results: High fear of falling was reported by 61.5% of participants, while a substantial proportion (35.9%) demonstrated moderate-to-high fall risk on the TT, despite the majority being classified as low risk. SF-36 domain scores indicated moderate HRQoL with substantial interindividual variability across dimensions. Strong correlations were found between SF-36 and FES-I (rs = 0.76, p < 0.001), TT (rs = −0.78, p < 0.001), Barthel Index (rs = −0.71, p < 0.001), and NIHSS (rs = 0.65, p < 0.001). Patients with greater neurological impairment and lower independence demonstrated worse HRQoL and higher fear of falling. Also, a statistically significant (p < 0.001) strong negative correlation (rs = −0.89) was found between the TT and the FES-I scores, indicating that higher fear of falling was associated with poorer mobility. Conclusions: Fear of falling, impaired balance, and reduced HRQoL are highly prevalent and strongly interconnected among post-stroke inpatients. These findings highlight the need for early multidimensional assessment and integrated interventions targeting both physical performance and psychological factors. Larger longitudinal studies are required to clarify causal pathways and optimize rehabilitation strategies.

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