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

<b>Background/Objectives</b>: 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. <b>Methods</b>: 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). <b>Results</b>: 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, <i>p</i> < 0.001), TT (rs = -0.78, <i>p</i> < 0.001), Barthel Index (rs = -0.71, <i>p</i> < 0.001), and NIHSS (rs = 0.65, <i>p</i> < 0.001). Patients with greater neurological impairment and lower independence demonstrated worse HRQoL and higher fear of falling. Also, a statistically significant (<i>p</i> < 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. <b>Conclusions</b>: 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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Publication Details

Journal
Journal of Clinical Medicine
Published
2026-02-25
DOI
https://doi.org/10.3390/jcm15051749
Primary Topic
Balance, Gait, and Falls Prevention
Type
article
Field-Weighted Citation Impact
0.00
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article

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

Maciej Miś, Adam Druszcz, Robert Dymarek, Marcin Miś et al.
Journal of Clinical Medicine
Balance, Gait, and Falls Prevention
article

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

Maciej Miś, Adam Druszcz, Robert Dymarek, Marcin Miś, Małgorzata Paprocka-Borowicz, Joanna Rosińczuk, Kacper Krysiak
article en

Abstract

<b>Background/Objectives</b>: 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. <b>Methods</b>: 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). <b>Results</b>: 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, <i>p</i> < 0.001), TT (rs = -0.78, <i>p</i> < 0.001), Barthel Index (rs = -0.71, <i>p</i> < 0.001), and NIHSS (rs = 0.65, <i>p</i> < 0.001). Patients with greater neurological impairment and lower independence demonstrated worse HRQoL and higher fear of falling. Also, a statistically significant (<i>p</i> < 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. <b>Conclusions</b>: 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.

Journal of Clinical MedicineVol. 15(5)
Wroclaw Medical University (PL), Witelon State University of Applied Sciences in Legnica (PL), Łukasiewicz Research Network – PORT Polish Center for Technology Development (PL)
No poverty
Openalex Percentile: Top 46%
Balance, Gait, and Falls Prevention
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