Fear of Falling Restricts Activities of Daily Living after Total Hip Arthroplasty: A One-Year Longitudinal Study

OBJECTIVES: To determine the prevalence and time course in changes regarding the fear of falling and whether there are consequent restrictions in activities of daily living (ADL) after total hip arthroplasty (THA). METHODS: This is 1-year longitudinal observational study. We recruited ninety-eight patients before and after THA. Fear of falling was assessed for 12 ADLs preoperatively and postoperatively at 3, 6, and 12 months following THA. In addition, we asked patients to answer whether they had refrained from performing each ADL because of fear of falling. RESULTS: Fifty-two patients were enrolled for the analysis. The total fear of falling score during ADLs decreased with time after THA. The ADLs in which many patients (over 20%) felt fear even at 12 months were using the stairs (25%), sitting and standing from the floor (23%), and walking around the neighborhood (21%). Approximately 10% of patients were restricted in performing ADLs, such as sitting and standing from the floor, because of fear. CONCLUSIONS: Patients undergoing THA frequently experience fear of falling during some ADLs even at 1 year after the operation, which could cause ADL restrictions. CLINICAL IMPLICATIONS: Clinicians should evaluate fear of falling and institute rehabilitation programs individually to decrease excessive fear that might lead to ADL restrictions.