AUTHOR=Abdelfadil Heba Mohammed Gaber , Fahmy Ebtisam Mohamed , Abdelmegeed Shimaa Mohamed , Zakaria Hoda Mohammed , Darwesh Ashraf Ahmed , Kadry Ahmed Mahmoud , Elsayed Shereen Hamed , Aboeleneen Ahmed M. , Alshimy Ahmed Magdy 

TITLE=Effect of adding systematic desensitization to goal-directed paradigm on risk of falling in patients with stroke: a randomized controlled trial

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1285420

DOI=10.3389/fneur.2024.1285420

ISSN=1664-2295

ABSTRACT=Background: Improvement in rehabilitation outcomes for patients suffering from chronic stroke can be attained through systematic desensitization of their fear of falling, which in turn reduces the risk of falling. Purpose: to examine the effect of adding systematic desensitization to a goal-directed paradigm on functional performance, balance, the risk of falling, and fear of falling among chronic ischemic stroke patients.Methodology: Two equal groups of forty stroke patients of both sexes were randomly allocated. For eight weeks, group A received three sessions per week of combined treatment consisting of systematic desensitization and a goal-directed paradigm, while group B received only the goal-directed paradigm. The Timed Up and Go test (TUG) and Dynamic Gait Index (DGI) were used to assess function performance; the Berg Balance Scale (BBS) and Biodex fall risk index (FRI) were used to evaluate balance; and the 16-item Fall Efficacy Scale -International (FES-I) was used to evaluate fear of falling. At baseline and following treatment, all measurements were obtained. Results: Both groups (A and B) revealed a substantial increase in functional performance through a decrease in TUG and an increase of DGI, a decrease in the risk of falling, through the increase of BBS and the decrease of FRI, and a decrease in fear of falling (FES-I) after treatment, with superior improvement in group (A) with p-value <0.001. Conclusion: Systematic desensitization combined with a goal-directed paradigm has a superior effect on improving functional performance, reducing the risk of falling and the fear of falling in patients with stroke in comparison to a goal-directed paradigm only.