The Discrepancy Between Perceived Fall Efficacy and Actual Physical Performance Using TUG and Chair Rise Tests

Background: Falls are a leading cause of morbidity among older adults and are influenced by both physiological declines in mobility and psychological factors such as fall-related self efficacy. Previous studies suggest that subjective confidence in avoiding falls does not always align with objective functional performance. However, few studies have concurrently examined perceived fall efficacy alongside standardized physical performance measures such as the Timed Up and Go (TUG) and chair rise tests. This study aimed to examine the relationship between fall efficacy and objective functional performance in community-dwelling older adults. 

Methods: This cross-sectional study included 178 community-dwelling older adults. Fall efficacy was assessed using a validated instrument, such as the Falls Efficacy Scale International. Objective physical performance was measured using the TUG and the five times sit-to-stand (chair rise) test. Associations between fall efficacy and physical performance were analyzed using correlation analyses and multiple linear regression models, adjusting for demographic variables and health-related covariates, including multi morbidity. 

Results: Multiple linear regression analyses showed that functional mobility and health status were significant determinants of fall efficacy, whereas demographic factors were not. TUG performance emerged as the strongest independent predictor of fall efficacy (β = 0.208, p = 0.005), exceeding the effect of multi morbidity (β = 0.187, p = 0.012), while age and gender were not significant (p > 0.05). Chair rise performance was also significantly associated with fall efficacy (β = 0.176, p = 0.020), although its predictive strength was weaker than that of multi morbidity (β = 0.188, p = 0.013). These findings suggest that dynamic balance, reflected by TUG performance, is more closely related to perceived fall confidence than lower-limb strength alone. 

Conclusions: Perceived fall efficacy shows a complex relationship with objective physical performance. While poorer mobility and strength are generally associated with lower fall efficacy, self perceived confidence does not always reflect actual functional risk. These findings highlight the importance of integrating subjective and objective assessments in fall risk screening and intervention planning. 

Keywords: Fall Efficacy; Older-Adult; Physical Performance; TUG Test; Chair Rise Test