Effects of fear of falling on physical performance and quality of life in children with duchenne muscular dystrophy

Ipek, C., Investigation of the Effects of Fear of Falling on Physical Performance and Quality of Life in Children With Duchenne Muscular Dystrophy, Hacettepe University Graduate School Health Sciences Neurology Physiotherapy Master of Sciences Thesis, Ankara, 2019. This study was aimed to investigate the fear of falling (FOF) in children with Duchenne Muscular Dystrophy (DMD) and to assess the relationship between FOF and physical performance and quality of life. Thirty children with diagnosis of DMD whose ages were between 6 and 15 years and levels were between 1-5 according to Brooke Lower Extremity Functional Classification were included in the study. Demographic data of the participants were recorded. FOF in children with DMD was evaluated by a questionnaire formed by the study team by detecting the activities that children with neuromuscular disease may experience FOF and by organizing them in accordance with World Health Organization's International Classification of Functioning, Disability and Health (ICF). The questionnaire is called "Fear of Falling Questionnaire in Neuromuscular Diseases" (NMH-DKA) and the total score ranged between 0-68 which higher scores indicate higher degrees of FOF. Musculoskeletal system, fall history, physical performance, ambulation, quality of life and activity limitation of the subjects were evaluated and the results were recorded. The mean NMH-DKA score of the participants was 15.30±7.03. It was determined that there were moderate correlations between NMH-DKA scores of the cases and BAEFS (r=0.415, p=0.023), 6MWT (r=-0.461, p=0.015), step width (r=0.419, p=0.024), Pediatric Berg Balance Scale (r=-0.478, p≤0.01), Timed "Up and Go" test (r=0.489, p≤0.01) and ambulation levels (r=-0.537, p≤0.01). Furthermore, there was a moderate correlation between NMH-DKA and the Global Function Score of the Pediatric Outcomes Data Collection Instrument (r=-0.409, p=0.025). The results of the study demonstrated that the fear of falling in children with DMD is related to physical performance and quality of life and it is a remarkable issue from early period. Key Words: Duchenne Muscular Dystrophy, falling, physical performance, quality of life