Falls, Activity, and Participation

 Restriction of mobility and declines in ability to complete ADLs and IADLs are

severe consequences associated with falls [56, 138, 170]. All are negatively related to

decreased independence and quality of life. Stel and colleagues examined fall related

declines in functional status and physical activity [185]. Functional status was measured

with stair climbing, dressing, standing from a chair, cutting toenails, walking outside and

transportation. Physical activity changes were measured with walking, bicycling,

gardening, sport activities, and light and heavy household activities. Post-fall declines in

functional status were reported by 35.3% of their sample and 15.2% reported declines in

physical activity. Vellas et al. determined that those who fell in a prospective study

demonstrated restricted activity and decreased independence at 6 months [138].

 Tinetti and Williams completed a study to determine the impact of falls and fall

related injuries on ADLs, IADLs, social activity, and advanced physical activities in a

community dwelling elderly population [141]. At one and three years, falling was

associated with declines in ADLs, IADLs, and social participation. Those with multiple

falls experienced greater declines in activity and participation and those with injurious

falls also demonstrated declines in advanced physical activity. An association between

declines in activity and falls incidence and/or severity of injury was demonstrated, thus

indicating a "dose response" relationship between falls and functional losses.

 Yardley and Smith examined the most commonly held beliefs regarding falls and

activity curtailment [186]. The Consequences of Falling (CoF) Scale was developed and

validated by the authors. It assessed types of fear related to falls, such as fear of physical

injury, fear of long-term functional incapacity, fear of subjective anxiety, and fear of

social discomfort. Demographics, mobility level, use of a walking aide, falls history and