Overestimation of Balance Ability Among Older Adults at Risk for Falls.

Objective: This study examined alignment of subjective balance confidence with Stopping Elderly Accidents, Deaths and Injuries (STEADI) fall risk. Methods: Cross-sectional analysis of 155 community-dwelling adults (60 + y/o) from 2016 to 2018 who completed a STEADI fall assessment. Descriptive statistics, Chi-Square analysis, and biserial point correlations were applied. Results: Adults who overestimate balance confidence, 55.6% (n = 50) reported a fall in the past year, 62.2% (n = 56) were worried about falling, 48.9% (n = 44) felt unsteady when standing/walking, and 70.0% (n = 63) had a score of ≥4 on the Stay Independent Questionnaire (SIQ). Physical performance for these adults were mean TUG score 10.9s (SD = 3.4), mean 30 second chair stands 10.8 (SD = 3.5), and mean 4-stage balance score 3.1 (SD = .76). Discussion: Older adults are more likely to overestimate their subjective balance confidence. Individuals are equally likely to have reported a fall in the past year if they were "at fall risk," regardless of their subjective balance confidence.

The Time Is Now: Leveraging the Affective Domain in PT Education and Clinical Practice.

BACKGROUND AND PURPOSE: The traditional domains of learning are cognitive, psychomotor, and affective. These parallel the habits of head, hand, and heart as the foundations for knowing, doing, and being in health professions education. Physical therapy education is deeply rooted in a cognitive (head) and psychomotor (hand) taxonomy despite the mission, vision, and values of the profession that embody the knowledge, skills, and attitudes (KSAs) requiring competence in the affective (heart) domain. Recently, the Model for Excellence and Innovation in Physical Therapy Education and the American Council of Academic Physical Therapy excellence framework in academic physical therapy identified pedagogical variables grounded in the affective domain (AD), including shared beliefs and values, partnerships and collaborations, leadership and innovation, social responsibility and inclusion, and a drive for excellence with high expectations. POSITION AND RATIONALE: Fully integrating the AD into physical therapy education equips the future of the profession with the KSAs to achieve the mission and vision, meet stakeholder needs, and endure the demands of clinical practice. DISCUSSION AND CONCLUSION: Explicitly using the AD in physical therapy education is imperative to the success and sustainability of the profession and in meeting critical societal needs. Engaging all learners in the AD does not require monumental curricular change. Intentional activities and strategies can develop the humanistic values of the learner across a curriculum and can shift the culture of academia from primarily cognitive and psychomotor to one that is comprehensive across all domains. The AD informs the cognitive and psychomotor aspects of learning and has direct implications for clinical practice in meeting stakeholder needs.