Treating Fear: Imbalance, Pain, Reinjury, Incontinence,
and Beyond (Recorded Webinar)

Video Runtime: 160 Minutes; Learning Assessment Time: 19 Minutes

In 1933, President Franklin D. Roosevelt said, “The only thing we have to fear is fear itself.” Fear is the most pervasive barrier inhibiting recovery and function across the life span. Fear-avoidant behavior is well established as a reason not to move. However, fear also impacts how we move (symmetry, speed, compensations), offering opportunities for intervention. Changes due to fear include reduced step length, foot clearance, and gait speed for persons with fear of falling; urgency in those with incontinence; limited head motion for those with fear of dizziness; gait deviations, word-finding difficulties, and altered UE biomechanics after stroke; depression in MCI; and movement substitutions to retrieve something from the floor or arise to standing for those in fear of pain. Functionally, we see the consequence of reduced participation (movement, social, vocational) as an unfortunate and unnecessary commonality of all. The time has come for PTs, OTs, and SLPs to recognize that we must directly treat fear itself, not just as a consequence of physical impairments (imbalance, weakness, pain, tone, dizziness) or cognitive impairments (word-finding, reduced working memory). We must come together in addressing fear directly, accomplishing this by systematically addressing the common threads of maladaptive neuroplasticity (sensory, motor, psychological) that lead to altered motor control and limited participation emanating from fear.