Please use this identifier to cite or link to this item:
Title: The reliability and validity of the survey of activities and fear of falling in the elderly for assessing fear and activity avoidance among stroke survivors
Authors: Liu, TW 
Ng, SSM 
Issue Date: 2019
Publisher: Public Library of Science
Source: PLoS one, 1 Apr. 2019, v. 14, no. 4, e0214796, p. 1-11 How to cite?
Journal: PLoS one 
Abstract: Introduction Activity restriction due to fear of falling is a common problem after a stroke. It can lead to deteriorated physical condition, restricted social participation and deprived quality of life. The Survey of Activities and Fear of Falling in the Elderly (SAFE) was developed to assess these difficulties, and its utility has been demonstrated among the older adults and older people with Parkinson's disease. This study aimed to expand those demonstrations to community-dwelling chronic stroke survivors using a Chinese translation of the instrument.
Methods One hundred and eight elderly individuals with a history of stroke completed the Chinese version of the SAFE (SAFE-C). The internal consistency of their responses was assessed using Cronbach's alpha. Twenty of the same subjects were reassessed after a 1-week interval to assess the instrument's test-retest reliability. Structure validity was examined by exploratory factor analysis. Pearson correlation was used to establish the instrument's convergent validity with respect to the results from the Chinese version of the Activities-specific Balance Confidence Scale (ABC-C) and the Chinese version of the Lawton Instrumental Activities of Daily Living scale (IADL-C).
Results The items of the SAFE-C demonstrated excellent internal consistency with a Cronbach's alphas of 0.90. The SAFE-C also had excellent test-retest reliability with an overall intra-class correlaton coefficient of 0.91. A 1-factor structure termed "fear avoidance circumstances" was identified and it was shown to be consistent with the original measure developed among community-living older people. The correlations between the SAFE-C and the ABC-C (r = -0.68) and the IADL-C (r = -0.57) confirmed the convergent validity.
Conclusions Fear avoidance behavior is a homogeneous construct applicable to people with stroke-specific impairments alike. The SAFE-C is a reliable and valid instrument for measuring the level of fear avoidance behavior among community-dwelling stroke survivors. Stroke survivors with good functional mobility revealed a low level of fear and avoidance as measured by the SAFE-C.
EISSN: 1932-6203
DOI: 10.1371/journal.pone.0214796
Rights: Copyright: © 2019 Liu, Ng. This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
The following publication Liu T-W, Ng SSM (2019) The reliability and validity of the Survey of Activities and Fear of Falling in the Elderly for assessing fear and activity avoidance among stroke survivors. PLoS ONE 14(4): e0214796, 11 pages is available at
Appears in Collections:Journal/Magazine Article

Files in This Item:
File Description SizeFormat 
Liu_Survey_Activities_Fear.pdf408.99 kBAdobe PDFView/Open
View full-text via PolyU eLinks SFX Query
Show full item record
PIRA download icon_1.1View/Download Contents

Page view(s)

Citations as of Jul 16, 2019


Citations as of Jul 16, 2019

Google ScholarTM



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.