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首页> 外文期刊>Physiotherapy theory and practice >Integration of cognitive-behavioral therapy with gait training for a 58-year-old male with a fear of falling: A case report
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Integration of cognitive-behavioral therapy with gait training for a 58-year-old male with a fear of falling: A case report

机译：一名58岁恐惧摔倒的男性认知行为疗法与步态训练的结合：一例报告

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Fear of falling is a common concern among adults over age 65, which results in decreased activity levels. Cognitive-behavioral therapy (CBT) uses psychological techniques to redirect negative cognitive, emotional, or behavioral affects for improvement of self-efficacy and reduced fear of falling. The purpose of this case study is to describe the integration of CBT into the physical therapy (PT) management of a middle-aged male with fear of falling and difficulty walking. The single subject was a 58-year-old male with complaints of frequently losing his balance, feeling unstable while walking, and requiring the use of a walker to ambulate. During the initial PT examination his primary impairment was difficulty ambulating in open spaces. Dynamic Gait Index (DGI) was 8/24 and the Modified Falls Efficacy Score (MFES) was 6.36/10. The interventions began with a general lower extremity strengthening program, balance exercises, and gait training. At visit 9, CBT techniques of cognitive restructuring were added. Visualization of correct gait patterns was added to the program during visit 10, which continued until discharge after visit 14. Measurements on the DGI improved to 23/24 and MFES improved to 9.43/10 at discharge. Gait pattern improved with the ability to ambulate indoors without an assistive device and using only a straight cane for community ambulation. The use of CBT is well documented as a group intervention for older adults with fear of falling, but CBT techniques may also be helpful for younger adults with fear of falling.
机译：跌倒的恐惧是65岁以上成年人普遍关注的问题，这会导致活动水平下降。认知行为疗法（CBT）使用心理技术来重定向负面的认知，情感或行为影响，以提高自我效能并降低跌倒的恐惧感。本案例研究的目的是描述将CBT整合到中年男性恐惧跌倒和行走困难的物理治疗（PT）管理中。唯一的受试者是一名58岁的男性，他抱怨自己经常失去平衡，走路时感觉不稳定，并需要使用助行器行走。在最初的PT检查期间，他的主要障碍是难以在露天场所行走。动态步态指数（DGI）为8/24，改良的跌倒效能评分（MFES）为6.36 / 10。干预从一般的下肢强化计划，平衡练习和步态训练开始。在第9次访问时，添加了认知重构的CBT技术。在第10次访问期间，将正确步态模式的可视化添加到程序中，并持续到第14次访问后出院。DGI的测量结果改善至23/24，MFES改善至9.43 / 10。步态得以改善，无需借助辅助设备即可在室内移动，而仅使用直拐杖进行社区移动即可。 CBT的使用已被很好地证明是对担心跌倒的老年人进行集体干预的方法，但是CBT技术对于害怕跌倒的年轻人也可能有帮助。

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