fear related activity restriction. During the initial assessment, 27.8% participants reported

a fall, 20.8% expressed fear of falling, and 46.2% of those with fear of falling had

curtailed activities. At follow-up, nonfallers with fear were more likely to report falls

than those without fear (32.6% vs 17.9%). Fallers with no fear of falling at baseline were

twice as likely than nonfallers to report fear at follow-up (20.6% vs. 11.6%). Regardless

of fall status, all who expressed fear of falling at baseline were very likely to express fear

again at 20 months.

 Researchers have discussed "evidence of a spiraling effect of increasing falls, fear,

and functional decline" [114]. They stated fear of falling is not only an acute outcome

secondary to falls, but "more likely recognition of being at risk, both of falling and of the

adverse outcomes that can result from falls". Additionally it was concluded that once fear

develops, it is likely to persist and influence activities and future fall rates.

 Mobility in the Post-Stroke Population

Stroke and Mobility Impairment

 Post-stroke residual deficits may exacerbate the mobility issues of the community

dwelling elderly population. Such mobility impairments may negatively gait speed, falls,

and fear of falling after a stroke.

Stroke

 Stroke is the primary cause of disability and is the third leading cause of death for

those over the age of 65 [1-4]. The American Heart Association reports stroke as a

common neurological event occurring in 700,000 people annually; over 4 million are

living with residual deficits [159]. O'Sullivan has defined a stroke, or cerebrovascular

accident (CVA), as "an acute onset of neurological dysfunction due to an abnormality in

cerebral circulation with resultant signs and symptoms that correspond to involvement of