High incidence of falls and fall-related injuries in wheelchair users with spinal cord injury: A prospective study of risk indicators
Emelie Butler Forslund, Vivien Jørgensen , Erika Franzén, Arve Opheim, Åke Seiger, Agneta Ståhle, Claes Hultling, Johan K. Stanghelle, Kirsti Skavberg Roaldsen, Kerstin Wahman
Department of Neurobiology, Care Sciences and Society , Division of physiotherapy, 141 83 Huddinge, Sweden. E-mail: firstname.lastname@example.org
Objective: To identify risk indicators for, and incidence of, recurrent falls and fall-related injuries in wheelchair users with traumatic spinal cord injury.
Design: Prospective multi-centre study.
Subjects: One hundred and forty-nine wheelchair users with spinal cord injury attending follow-up in Sweden and Norway.
Methods: Inclusion criteria: wheelchair users ≥ 18 years old with traumatic spinal cord injury ≥ 1 year post-injury. Exclusion criteria: individuals with motor complete injuries above C5. Falls were prospectively reported by text message every second week for one year and were followed-up by telephone interviews. Outcomes were: fall incidence, risk indicators for recurrent (> 2) falls and fall-related injuries. Independent variables were: demographic data, quality of life, risk willingness, functional independence, and exercise habits.
Results: Of the total sample (n = 149), 96 (64%) participants fell, 45 (32%) fell recurrently, 50 (34%) were injured, and 7 (5%) severely injured. Multivariate logistic regression analysis showed that reporting recurrent falls the previous year increased the odds ratio (OR) of recurrent falls (OR 10.2, p < 0.001). Higher quality of life reduced the OR of fall-related injuries (OR 0.86, p = 0.037).
Conclusion: Previous recurrent falls was a strong predictor of future falls. The incidence of falls, recurrent falls and fall-related injuries was high. Hence, prevention of falls and fall-related injuries is important.
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