Exploring the relationship between fear of falling and physical activity in obese women under 50 years of age

Abstract

Despite widespread promotion of the benefits of regular activity, uptake by obese adults, particularly women, remains low. There is limited research on the physical barriers to exercise in younger obese adults, yet studies in elderly women suggested a relationship between obesity, fear of falling (FOF) and activity participation. It is feasible that FOF might be a problem in younger obese women and a subsequent barrier to activity participation.
The aim of this thesis was to explore the phenomenon of FOF in obese women under 50 years of age and to develop a conceptual framework to explain its relationship to activity participation. An exploratory mixed methods approach was used. An initial study of 12 obese women used semi-structured interviews to elicit original knowledge of concerns they had about falling when active, which was analysed using a thematic approach. Eight participants reported FOF and there were suggestions that FOF led to activity avoidance. Younger participants and those more active were less likely to report problems. The results were used to develop a conceptual framework of FOF which informed the design of a larger study to measure the relationship between FOF and activity level in obese women.
A review of FOF instruments to identify those appropriate for use in a further study of obese women was completed. Sixty-three participants completed self-reported questionnaires that measured different constructs of FOF, notably, falls-efficacy, feared consequences of falling and activity avoidance. Statistical analysis confirmed FOF to be an independent predictor of current low activity, irrespective of age, BMI or depression. These findings shed light on an important issue which could be used to inform the design of interventions to promote activity in overweight women. The development of such interventions that target FOF in obesity warrants further investigation.