Category: Spinal Cord Injury; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development)
To compare the six-month incidence proportions, causes and consequences of falls among community-dwelling wheelchair users and ambulators with spinal cord injury (SCI).
Design : A prospective observational study.
Participants (or Animals, Specimens, Cadavers) :
A volunteer sample of 65 adults (32 wheelchair users, aged 50±11 years and 33 ambulators, aged 62±13 years) with chronic, traumatic SCI (C1-L1, AIS A-D) participated.
Main Outcome Measure(s) :
Information pertaining to the number of falls experienced in six months, circumstance of each fall (i.e. location, time of day, contributing factors), and type of fall-related injury was collected from each participant through surveys (online or paper) and monthly phone calls. Chi-square tests were used to compare categorical variables between groups (α=0.05).
Results : There were no differences between ambulators and wheelchair users in the incidence proportion of falls (58% and 52%, respectively, fell at least once during the study period, p=0.72) or fall-related injuries (37% and 33%, respectively, p=0.70). The time of day of the fall differed between groups, with more ambulators (73%) falling during the daytime than wheelchair users (50%; p=0.022). There were no group differences in the location of falls (p=0.95); most falls occurred within the home environment (63%). Ambulators perceived biological factors (e.g. muscle weakness in legs) contributing to the majority (60%) of falls, while wheelchair users attributed their falls to behavioural (40%; e.g. rushing) or biological (e.g. spasms; 35%) factors.
The six-month incidence proportions of falls and fall-related injuries were similar between ambulators and wheelchair users with SCI. The perceived causes of falls differed between the groups, suggesting the need for fall prevention initiatives tailored to mobility status.
Hardeep Singh– PhD Candidate, University of Toronto, Toronto, Ontario
Heather Flett– Advanced Practice Leader, University Health Network - Toronto Rehab, Lyndhurst Centre, Toronto, Ontario
Sander Hitzig– Scientist, St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario
Anita Kaiser– Director of Research, Canadian Spinal Research Organization, Toronto, Ontario
Beverley Catharine Craven– Senior Scientist/Associate Professor, Dept of Medicine Unversity Health Network, University of Toronto, Toronto, Ontario
Susan Jaglal– Professor & Interim Chair, University of Toronto, Toronto, Ontario
Kristin Musselman– Scientist/Assistant Professor, KITE, Toronto Rehabilitation Institute-University Health Network; Dept. of Physical Therapy, Faculty of Medicine, University of Toronto, Toronto, Ontario