|
Abstract
|
OBJECTIVE: To identify risk factors for falls and fall-related injuries for wheelchair users with spinal cord injury (SCI).
DESIGN: Cross-sectional study. SETTING: Community setting. PARTICIPANTS: Fifty-nine community dwelling wheelchair users (N=59), 47.5% male, median age of 52.5 years (IQR, 21 years) with chronic SCI, median time since injury of 16.6 years (IQR, 27.3 years). INTERVENTIONS: No intervention. MAIN OUTCOME MEASURES: Outcomes were incidence of falls and fall-related injuries. Participants reported on falls and fall-related injuries experienced in the previous 6 months. Independent variables were self-reported and performance-based measures. Self-reported measures included demographics, characteristics of SCI, fear of falling, psychological measures, functional independence, wheelchair skills, environmental barriers, quality of life, and community participation. Performance-based measures included transfer quality and sitting balance assessments. Logistic regression analyses were conducted to identify factors influencing falls and fall-related injuries.
RESULTS: In total, 152 falls and 30 fall-related injuries were reported from a total of 37 fallers. After logistic regression analysis, the model with the greatest levels of clinical utility and discriminative ability for falls (sensitivity 81%; specificity 55%; area under the receiving operating characteristic curve [AUC] statistics=0.73; 95% CI, 0.60-0.86) included the variables of shorter time since SCI, high mobility level, and having received education on fall prevention. The model for fall-related injuries (sensitivity 79%; specificity 75%; AUC statistics=0.77; 95% CI, 0.59-0.96) included the variables of older male individual, lower physical health score, and having received education on fall prevention.
CONCLUSIONS: The regression models presented may be used to identify wheelchair users with SCI at greater risk of falls and fall-related injuries. The findings may help to refer those in need to tailored fall and fall-related injury prevention programs. The findings presented in this study were based on a relatively small sample convenience; therefore, further prospective studies with a larger sample size are warranted.
Language: en |
|
Keywords
|
Wheelchairs; Rehabilitation; Accidental falls; Risk factors; OR, odds ratio; ADL, activities of daily living; AIS, American Spinal Injury Association Impairment Scale; AUC, area under the receiver operating characteristic curve; FOF, fear of falling; QOL, quality of life; SCI, spinal cord injury; SCIM III, Spinal Cord Independence Measure III; Spinal cord injuries; TAI, Transfer Assessment Instrument; WHOQOL-BREF, World Health Organization Quality of Life-Brief Version; WST, Wheelchair Skill Test |