Ann Rehabil Med.  2019 Apr;43(2):195-203. 10.5535/arm.2019.43.2.195.

Correlation of the Korean Version of Falls Efficacy Scale-International With Quantitative Balance and Gait Parameters Through Exercise Program in Elderly Men

  • 1Department of Physical Medicine and Rehabilitation, Veterans Health Service Medical Center, Seoul, Korea.


To determine correlation of the Korean version of Falls Efficacy Scale-International (KFES-I) with other gait and balance parameters through exercise program in older men.
Between July 2015 and April 2018, 50 men of 103 participants in an exercise program for preventing falls who aged over 60 years, completed the evaluation before and after the program, had fear of falling (FOF), and could walk independently as an outpatient were enrolled retrospectively. The program comprised lower extremities and core muscle strengthening exercises following stretching exercises twice a week for 8 weeks. FOF using the KFES-I, Berg Balance Scale (BBS), Modified Barthel Index (MBI), stair up and gait categories in MBI (MBI-gait), and Timed Up and Go test (TUG) were evaluated. Quantitative gait and balance parameters were measured by gait analysis, posturography, and isokinetic dynamometer. They were compared before and after the program. Moreover, correlations of KFES-I with other parameters were examined.
Fifty participants were enrolled. After the program, significant improvements were noted in right stride length (p=0.013) in gait analysis, MBI (p=0.012), BBS (p<0.000), TUG test (p<0.000), and KFES-I (p<0.000) scores. KFES-I was significantly correlated with MBI (r=-0.35, p=0.013), and MBI-gait (r=-0.341, p=0.015).
Risk of falls could be significantly improved through exercise. KFES-I had significant correlations with MBI-gait parameters. Participants showed increases in gait and balancing ability on quantitative measurements through exercises. Therefore, regular stretching, strengthening, and balancing exercises may help prevent falls in older people.


Elderly; Exercise; Koreans; Falls; Fear

MeSH Terms

Accidental Falls*
Asian Continental Ancestry Group
Lower Extremity
Retrospective Studies


1. Liu Y, Chan JS, Yan JH. Neuropsychological mechanisms of falls in older adults. Front Aging Neurosci. 2014; 6:64.
2. Ambrose AF, Paul G, Hausdorff JM. Risk factors for falls among older adults: a review of the literature. Maturitas. 2013; 75:51–61.
3. Casey CM, Parker EM, Winkler G, Liu X, Lambert GH, Eckstrom E. Lessons learned from implementing CDC’s STEADI falls prevention algorithm in primary care. Gerontologist. 2017; 57:787–96.
4. Sohng KY, Moon JS, Song HH, Lee KS, Kim YS. Risk factors for falls among the community-dwelling elderly in Korea. Taehan Kanho Hakhoe Chi. 2004; 34:1483–90.
5. Auais M, Alvarado B, Guerra R, Curcio C, Freeman EE, Ylli A, et al. Fear of falling and its association with life-space mobility of older adults: a cross-sectional analysis using data from five international sites. Age Ageing. 2017; 46:459–65.
6. Zijlstra GA, van Haastregt JC, van Eijk JT, van Rossum E, Stalenhoef PA, Kempen GI. Prevalence and correlates of fear of falling, and associated avoidance of activity in the general population of community-living older people. Age Ageing. 2007; 36:304–9.
7. Scheffer AC, Schuurmans MJ, van Dijk N, van der Hooft T, de Rooij SE. Fear of falling: measurement strategy, prevalence, risk factors and consequences among older persons. Age Ageing. 2008; 37:19–24.
8. Friedman SM, Munoz B, West SK, Rubin GS, Fried LP. Falls and fear of falling: which comes first? A longitudinal prediction model suggests strategies for primary and secondary prevention. J Am Geriatr Soc. 2002; 50:1329–35.
9. Young WR, Mark Williams A. How fear of falling can increase fall-risk in older adults: applying psychological theory to practical observations. Gait Posture. 2015; 41:7–12.
10. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990; 45:P239–43.
11. Powell LE, Myers AM. The Activities-specific Balance Confidence (ABC) scale. J Gerontol A Biol Sci Med Sci. 1995; 50A:M28–34.
12. Yardley L, Beyer N, Hauer K, Kempen G, Piot-Ziegler C, Todd C. Development and initial validation of the Falls Efficacy Scale-International (FES-I). Age Ageing. 2005; 34:614–9.
13. Dewan N, MacDermid JC. Fall Efficacy Scale-International (FES-I). J Physiother. 2014; 60:60.
14. Park G, Cho B, Kwon IS, Park BJ, Kim T, Cho KY, et al. Reliability and validity of Korean version of Falls Efficacy Scale-International (KFES-I). J Korean Acad Rehabil Med. 2010; 34:554–9.
15. Kim KI, Jung HK, Kim CO, Kim SK, Cho HH, Kim DY, et al. Evidence-based guidelines for fall prevention in Korea. Korean J Intern Med. 2017; 32:199–210.
16. Clemson L, Singh MF, Bundy A, Cumming RG, Weissel E, Munro J, et al. LiFE pilot study: a randomised trial of balance and strength training embedded in daily life activity to reduce falls in older adults. Aust Occup Ther J. 2010; 57:42–50.
17. Cadore EL, Rodriguez-Manas L, Sinclair A, Izquierdo M. Effects of different exercise interventions on risk of falls, gait ability, and balance in physically frail older adults: a systematic review. Rejuvenation Res. 2013; 16:105–14.
18. Park Y, Chang M. Effects of the Otago exercise program on fall efficacy, activities of daily living and quality of life in elderly stroke patients. J Phys Ther Sci. 2016; 28:190–3.
19. Schache AG, Baker R, Vaughan CL. Differences in lower limb transverse plane joint moments during gait when expressed in two alternative reference frames. J Biomech. 2007; 40:9–19.
20. Arfken CL, Lach HW, Birge SJ, Miller JP. The prevalence and correlates of fear of falling in elderly persons living in the community. Am J Public Health. 1994; 84:565–70.
21. Cumming RG, Salkeld G, Thomas M, Szonyi G. Prospective study of the impact of fear of falling on activities of daily living, SF-36 scores, and nursing home admission. J Gerontol A Biol Sci Med Sci. 2000; 55:M299–305.
22. Lim JY, Lim JY, Park JA, Oh MK, Park WB, Kang EK, et al. Short-term and long-term effects of integrated fall prevention program in the Korean elderly. J Korean Acad Rehabil Med. 2010; 34:451–7.
23. Azad A, Hassani Mehraban A, Mehrpour M, Mohammadi B. Clinical assessment of fear of falling after stroke: validity, reliability and responsiveness of the Persian version of the Fall Efficacy Scale-International. Med J Islam Repub Iran. 2014; 28:131.
24. Gazibara T, Tepavcevic DK, Svetel M, Tomic A, Stankovic I, Kostic VS, et al. Recurrent falls in Parkinson’s disease after one year of follow-up: a nested case-control study. Arch Gerontol Geriatr. 2016; 65:17–24.
25. Jung Y, Lee K, Shin S, Lee W. Effects of a multifactorial fall prevention program on balance, gait, and fear of falling in post-stroke inpatients. J Phys Ther Sci. 2015; 27:1865–8.
26. Barnett A, Smith B, Lord SR, Williams M, Baumand A. Community-based group exercise improves balance and reduces falls in at-risk older people: a randomized controlled trial. Age Ageing. 2003; 32:407–14.
27. Sherrington C, Whitney JC, Lord SR, Herbert RD, Cumming RG, Close JC. Effective exercise for the prevention of falls: a systematic review and meta-analysis. J Am Geriatr Soc. 2008; 56:2234–43.
28. Cameron ID, Dyer SM, Panagoda CE, Murray GR, Hill KD, Cumming RG, et al. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database Syst Rev. 2018; 9:CD005465.
29. Freiberger E, Haberle L, Spirduso WW, Zijlstra GA. Long-term effects of three multicomponent exercise interventions on physical performance and fall-related psychological outcomes in community-dwelling older adults: a randomized controlled trial. J Am Geriatr Soc. 2012; 60:437–46.
30. Paul SS, Thackeray A, Duncan RP, Cavanaugh JT, Ellis TD, Earhart GM, et al. Two-year trajectory of fall risk in people with Parkinson disease: a latent class analysis. Arch Phys Med Rehabil. 2016; 97:372–379. e1.
31. Donoghue OA, Cronin H, Savva GM, O’Regan C, Kenny RA. Effects of fear of falling and activity restriction on normal and dual task walking in community dwelling older adults. Gait Posture. 2013; 38:120–4.
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