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Falls-Related Self-Efficacy Is Independently Associated With Balance and Mobility in Older Women With Low Bone Mass

¹ UBC Bone Health Research Group: Centre for Hip Health, BC Women's Hospital and Health Centre Osteoporosis Program, and Faculty of Medicine, University of British Columbia, Vancouver, Canada.
Departments of ² Orthopaedics, ³ Psychology, ⁴ Human Kinetics, and ⁵ School of Rehabilitation Sciences, University of British Columbia, Vancouver, Canada.
⁶ Rehabilitation Research Laboratory, GF Strong Rehabilitation Center, Vancouver, Canada.
Departments of ⁷ Family Practice and ⁸ Health Care and Epidemiology, University of British Columbia, Vancouver, Canada.
⁹ Prince of Wales Medical Research Institute, University of New South Wales, Randwick, Sydney, Australia.

Address correspondence to Karim M. Khan, MD, PhD, Department of Family Practice, Faculty of Medicine, University of British Columbia, Suite 211-2150 Western Parkway, Vancouver, BC, Canada, V6T 1V6. E-mail: kkhan{at}interchange.ubc.ca or dtambrose{at}shaw.ca (Dr. Teresa Liu-Ambrose, PhD, PT).

Background. It is currently unknown whether falling is independently associated with measures of balance and mobility in older adults after accounting for relevant physiological functions. This cross-sectional study assessed the independent association of falls-related self-efficacy to balance and mobility after accounting for age, current physical activity, and performances in relevant physiological domains in 98 older women, aged 75–86 years, with low bone mass.

Methods. Falls-related self-efficacy was assessed by the Activities-Specific Balance Confidence Scale (ABC Scale). Measures of balance and mobility included the 13-item Community Balance and Mobility Scale (CB & M Scale) and gait speed under two conditions: normal-paced and fast-paced. Physiological assessment included postural sway, foot reaction time, dominant quadriceps and dorsiflexor strength, proprioception, tactile sensitivity, edge contrast sensitivity, and visual acuity.

Results. Falls-related self-efficacy was independently associated with both balance and mobility after accounting for age, current physical activity level, and performances in relevant physiological domains. Based on the standardized ß coefficients, the ABC Scale score was more associated with measures of balance and mobility than measures of physiological function.

Conclusion. These results highlight the independent association of falls-related self-efficacy with physical performance in older women with low bone mass. Thus, clinicians may need to consider falls-related self-efficacy when assessing and treating balance and mobility in this population, and falls-related self-efficacy may be useful as a screening tool to identify those persons with impaired balance and mobility.