Comparing the causes, circumstances and consequences of falls across mobility statuses among individuals with spinal cord injury: A secondary analysis

Singh, Hardeep; Cheung, Lovisa; Chan, Katherine; Flett, Heather; Hitzig, Sander L.; Kaiser, Anita; Musselman, Kristin E.

doi:10.1080/10790268.2021.1956252

Cited by 6 publications

(8 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…People living with SCI/D have described their fall risk as individualized and multifactorial, whereby each individual has a unique set of risk factors that may interact to cause a fall [ 2 ]. The circumstances surrounding falls among the SCI/D population have been well described in recent years [ 3 ], with circumstances varying with mobility status [ 4 , 5 ]. Compared to wheelchair users with SCI/D, those who walk have a higher incidence proportion of falls [ 1 ] and experience the majority of their falls when walking or completing activities in standing [ 4 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

“…The circumstances surrounding falls among the SCI/D population have been well described in recent years [ 3 ], with circumstances varying with mobility status [ 4 , 5 ]. Compared to wheelchair users with SCI/D, those who walk have a higher incidence proportion of falls [ 1 ] and experience the majority of their falls when walking or completing activities in standing [ 4 , 6 , 7 ]. Similarly, the physical, psychological and social consequences of falling and living with a high fall risk after SCI/D have been described [ 3 , 6 , 8 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A qualitative photo-elicitation study exploring the impact of falls and fall risk on individuals with subacute spinal cord injury

et al. 2022

Self Cite

View full text Add to dashboard Cite

Background Individuals living with chronic spinal cord injury or disease (SCI/D) are at an increased risk of falling. However, little is known about the impact of falls and fall risk in the subacute phase of SCI/D, despite this being a time when fall prevention initiatives are delivered. Hence, we explored the impact of falls and fall risk in individuals with subacute SCI/D as they transitioned from inpatient rehabilitation to community living. Methods This qualitative photo-elicitation study used an inductive thematic analysis. Eight individuals (7 male) undergoing inpatient rehabilitation at a Canadian tertiary rehabilitation hospital due to a new SCI/D participated. Six months following discharge, photo-elicitation interviewing was used to understand the impact of falls and fall risk. Over 7–14 days, participants completed a photo-assignment that involved taking photographs in response to questions, such as what increases/decreases your likelihood of falling? A semi-structured interview followed, in which participants described their photographs and discussed their experiences with falls, fall risk and fall prevention training. Results Four themes were identified. 1) Risk factors and strategies identified through lived experience. Participants discovered their fall risk factors and fall prevention strategies through “trial and error”. 2) Influences on the individual’s perception of their fall risk. Prior experience with falls, including falls experienced by themselves as well as friends and family, influenced their perception of fall risk. 3) Experiencing life differently due to increased fall risk. A high fall risk reduced participation, increased negative emotions and decreased independence and quality of life. 4) Falls training in rehabilitation can be improved. Prior experiences with falls training varied; however, participants expressed a desire for comprehensive and individualized training. Conclusion Although participants’ experiences with falls and fall prevention varied, falls and the risk of falling can have a significant impact on the first year of living with a SCI/D.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A qualitative photo-elicitation study exploring the impact of falls and fall risk on individuals with subacute spinal cord injury

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…A comprehensive assessment of fall risk and fear of falling at the end of an individual's inpatient hospital stay is warranted. This assessment should consider the current mobility status of the individual, as fall risk and fall experiences differ between individuals with SCI who ambulate compared to those who use a wheelchair ( 52 , 53 ). Moreover, it would be important to consider whether an individual's mobility status is likely to change after hospital discharge.…”

Section: Discussionmentioning

confidence: 99%

Impact of Falls and Fear of Falling on Participation, Autonomy and Life Satisfaction in the First Year After Spinal Cord Injury

Chan

Perez

Singh

et al. 2022

Front. Rehabilit. Sci.

Self Cite

View full text Add to dashboard Cite

IntroductionIndividuals with spinal cord injury (SCI) experience reduced participation in meaningful activities, leading to reduced social engagement and negative psychological impact. Two factors that may affect participation post-SCI are fall status (e.g., having experienced a fall) and having a fear of falling. Our objective was to examine if and how fall status and fear of falling impact participation, autonomy and life satisfaction in the first year post-injury.MethodsAdult inpatients of a SCI rehabilitation hospital were recruited. Following discharge, falls were tracked for 6 months and participants who fell at least once were categorized as “fallers”. At the end of the 6-month period, the Impact on Participation and Autonomy Questionnaire and Life Satisfaction Questionnaire 9 were administered, and participants were asked if they had a fear of falling (i.e., an ongoing concern about falling leading to the avoidance of activities they are capable of doing). Falls were reported using descriptive statistics. Ordinary least squares regression was used to evaluate the relationships between the independent variables (i.e., fall status and fear of falling) and each dependent variable (i.e., questionnaire scores).ResultsSeventy-one individuals were enrolled in the study; however, 11 participants were lost to follow-up. The included participants (n = 60) were 58.4 ± 14.6 years old and 99 ± 60.3 days post-injury. Over one third (38.3%) of participants fell over the 6-month tracking period. Twenty-seven participants (45%) reported a fear of falling and 14 (51.9%) of these participants were fallers. Fear of falling significantly predicted scores of autonomy indoors (β = 3.38, p = 0.04), autonomy outdoors (β = 2.62, p = 0.04) and family role (β = 3.52, p = 0.05).ConclusionIndividuals with subacute SCI and a fear of falling experienced reduced participation and autonomy, but with no differences in life satisfaction compared to those without a fear of falling. In contrast, having experienced a fall did not impact participation, autonomy or life satisfaction. In the first year after SCI, rehabilitation programs should place specific attention on the presence of fear of falling to help individuals with SCI prepare for everyday mobility challenges.

show abstract

“… 49 Previously collected data from questionnaires of balance confidence (ie, Activities-specific Balance Confidence (ABC) Scale and WheelCon) were used to inform the estimated effect sizes of 0.3. 8 19 The sample size calculation in G*Power was performed considering that a repeated-measures analysis of variance (ANOVA) will be used to evaluate the effects of photovoice on balance confidence (ie, test family=F tests, statistical test=ANOVA: repeated measures, within factors). Power was set to 80% and alpha=0.05.…”

Section: Methods and Analysismentioning

confidence: 99%

“…For example, wheelchair users commonly fall in the afternoon or evening when transferring, reaching or propelling on uneven surfaces, while those who ambulate commonly fall in the mornings or afternoons when walking, standing or changing positions (eg, sitting to standing). 8 However, all people with SCI, regardless of mobility status, may experience significant physical, psychosocial and economic impacts from falling and/or living with a high fall risk. 9–11 …”

Section: Introductionmentioning

confidence: 99%

Protocol for a single group, mixed methods study investigating the efficacy of photovoice to improve self-efficacy related to balance and falls for spinal cord injury

Sessford

Chan²,

Kaiser³

et al. 2022

BMJ Open

Self Cite

View full text Add to dashboard Cite

IntroductionMany individuals living with spinal cord injury (SCI) experience falls and a fear of falling, both of which can impact participation in daily activities and quality of life. A single group, convergent mixed methods study will be conducted to examine the effects of a photovoice intervention on falls self-efficacy among individuals living with chronic SCI. Secondary objectives include examining the effects of photovoice on fear of falling, participation and quality of life and exploring participants’ experiences and perceptions of the photovoice intervention through qualitative interviews.Methods and analysisAdults with SCI (n=40) will be divided into groups according to their mobility status (ie, those who ambulate and those who primarily use a wheelchair). The study will be conducted virtually over three consecutive phases, totalling 30 weeks. Each group will self-report falls for 12 weeks prior to and following the intervention (phases 1 and 3, respectively). The 6-week photovoice intervention (phase 2) will be comprised of two photo assignments, two individual interviews with a researcher and a peer mentor, and four group meetings. Participants will discuss these photos at the interviews and group meetings. Standardised questionnaires of falls self-efficacy, fear of falling, participation and life satisfaction will be administered at four time points (ie, beginning of each phase and the end of phase 3). Questionnaire scores will be examined over time using repeated-measures analysis of variance. A semistructured interview will be completed at the end of phase 3 to gain feedback on the photovoice intervention. Qualitative data will be analysed using reflexive thematic analysis.Ethics and disseminationEthics approval was obtained prior to study enrolment. Findings will be shared through peer-reviewed scientific publications and participant-directed knowledge translation activities.Trial registration numberNCT04864262.

show abstract

Comparing the causes, circumstances and consequences of falls across mobility statuses among individuals with spinal cord injury: A secondary analysis

Cited by 6 publications

References 48 publications

A qualitative photo-elicitation study exploring the impact of falls and fall risk on individuals with subacute spinal cord injury

A qualitative photo-elicitation study exploring the impact of falls and fall risk on individuals with subacute spinal cord injury

Impact of Falls and Fear of Falling on Participation, Autonomy and Life Satisfaction in the First Year After Spinal Cord Injury

Protocol for a single group, mixed methods study investigating the efficacy of photovoice to improve self-efficacy related to balance and falls for spinal cord injury

Contact Info

Product

Resources

About