Falls, mobility, and physical activity after spinal cord injury: an exploratory study using photo-elicitation interviewing

Musselman, Kristin E.; Arnold, Catherine M.; Pujol, Clara; Lynd, Kaylea; Oosman, Sarah

doi:10.1038/s41394-018-0072-9

Cited by 31 publications

(52 citation statements)

References 29 publications

(59 reference statements)

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“…The results of this study support the idea that walking at a slower speed is a strategy used by individuals with iSCI to reduce fall risk. This same finding has been previously reported as a strategy learned by individuals with iSCI through practice with life experiences . Clinically, the assessment of balance control to identify individuals at risk of falls should be more comprehensive than merely evaluating stability during normal walking.…”

Section: Discussionsupporting

confidence: 82%

Walking Stability During Normal Walking and Its Association with Slip Intensity Among Individuals with Incomplete Spinal Cord Injury

Arora

Musselman

Lanovaz

et al. 2019

PM&R

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Section: Discussionsupporting

confidence: 82%

Walking Stability During Normal Walking and Its Association with Slip Intensity Among Individuals with Incomplete Spinal Cord Injury

Arora

Musselman

Lanovaz

et al. 2019

PM&R

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“…There remains a need to gain a more detailed understanding of the nature of falls in regard to this particular population 2 4. Few studies have used qualitative or mixed methods to explore the perspectives of wheelchair users with SCI concerning the causes and the impacts of falls 1 3 9. An in-depth exploration from the perspectives of wheelchair users can provide insight into priorities and potential strategies for fall prevention 3 4…”

Section: Introductionmentioning

confidence: 99%

“…One qualitative methodology that enables detailed insight into the perspectives of participants on a particular issue is photo-elicitation interviewing (PEI), which involves the incorporation of photographs into an interview 11 12. In a previous study, PEI was used to examine the perceived causes of falls and impact of fall risk on the mobility and physical activity levels of individuals with incomplete SCI 3. However, since the study sample was limited to individuals with motor incomplete SCI (ie, American Spinal Cord Injury Association Impairment Scale (AIS) grades C and D), more research is needed to understand the factors that contribute to falls in individuals with motor complete SCI (ie, AIS grades A and B).…”

Section: Introductionmentioning

confidence: 99%

“…Photo-elicitation is suited for addressing this knowledge gap. Through photo-elicitation, we can obtain a visual display of the participants’ experiences, situations and environments, as well as a verbal account of their experiences with falls/fall risk factors 3. As the perspectives of wheelchair users with SCI regarding the factors that increase and decrease their risk of falling remain understudied, here we used PEI to gain a more detailed understanding of: (A) the various risk factors associated with falls and (B) the strategies that can reduce their fall risk.…”

Section: Introductionmentioning

confidence: 99%

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Factors that influence the risk of falling after spinal cord injury: a qualitative photo-elicitation study with individuals that use a wheelchair as their primary means of mobility

et al. 2020

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IntroductionFalls are a concern for wheelchair users with spinal cord injury (SCI). Falls can negatively impact the physical and psychological well-being of fallers. To date, the perspectives of wheelchair users with lived experiences of SCI on the contributors to falls has been understudied. Information about factors that influence fall risk would guide the development of effective fall prevention strategies.ObjectivesTo gain a comprehensive understanding of the factors that influenced the risk of falling as perceived by wheelchair users with SCI.DesignA qualitative study using photo-elicitation interviews.SettingA Canadian SCI rehabilitation hospital and the participants’ home/community environments.ParticipantsTwelve wheelchair users living in the community with chronic SCI.MethodsParticipants captured photographs of situations, places or things that they perceived increased and decreased their risk of falling. Semistructured photo-elicitation interviews were conducted to discuss the content of the photographs and explore perceptions of fall risk factors. A hybrid thematic analysis and the Biological, Behavioural, Social, Economic, and Environmental model were used as a framework to organise/synthesise the data.ResultsOverall, the findings indicated that the risk of falling was individualised, complex and dynamic to each person’s life situation. Four main themes were revealed in our analysis: (1) Falls and fall risk caused by multiple interacting factors; (2) Dynamic nature of fall risk; (3) Single factors were targeted to reduce falls and fall-related injuries; and (4) Fall prevention experiences and priorities.ConclusionsEach wheelchair user encountered numerous fall risk factors in their everyday lives. Information from this study can be used to set priorities for fall prevention. Fall prevention initiatives should consider a wheelchair user’s fall risks in a holistic manner, acknowledging that a person’s current situation, as well as anticipating their fall risks and fall prevention needs, will change over time.

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“…A controlled fall that is part of therapy is different than an unintended or unexpected fall during therapy and this distinction is not recognized in the policies/procedures of the sites or in the widely accepted definition outlined above [26]. In order to support a practical approach to fall prevention training in SCI rehabilitation [9,27], the widely accepted definition of a fall/near fall must differentiate between a controlled therapy fall versus an unexpected/ unintended fall.…”

Section: Discussionmentioning

confidence: 99%

Current state of fall prevention and management policies and procedures in Canadian spinal cord injury rehabilitation

Singh

Flett

Silver

et al. 2020

BMC Health Serv Res

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Background: Preventing patient falls is a priority in tertiary spinal cord injury (SCI) rehabilitation. Falls can result in patient or staff injury, delayed rehabilitation, and hospital liability. A comprehensive overview of fall prevention/ management policies and procedures in Canadian SCI rehabilitation is currently lacking. We describe and compare the fall prevention/management policies and procedures implemented in Canadian tertiary hospitals that provide SCI rehabilitation. Methods: Fall prevention/management documents implemented in SCI rehabilitation at six Canadian tertiary rehabilitation hospitals across five provinces were analyzed using a document analysis. Analysis involved multiple readings of the documents followed by a content and thematic document analysis. Results: Fall prevention/management policies and procedures in SCI rehabilitation were organized into three main categories: 1) pre-fall policies and procedures; 2) post-fall policies and procedures; and, 3) communication between and amongst staff, patients, and families. Pre-fall policies and procedures encompassed: a) the definition of a fall; b) fall risk assessments in SCI rehabilitation; and, c) fall prevention strategies. The post-fall policies and procedures included: a) recovery from a fall; b) incident reporting process; and, c) fall classification. Components of fall prevention/management policies and practices that differed between hospitals included the fall risk assessments, post-fall huddles, and fall classifications. Conclusions: Fall prevention/management is a required organizational practice for all hospitals. Although Canadian tertiary hospitals that provide SCI rehabilitation have similar components of fall prevention/management policies and procedures, the specific requirements differ at each site. There is a need for evidence-informed, consensusdriven implementation of SCI-specific fall prevention and management procedures across Canadian SCI rehabilitation settings.

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Falls, mobility, and physical activity after spinal cord injury: an exploratory study using photo-elicitation interviewing

Abstract: Physiotherapy Foundation of Canada.

Cited by 31 publications

References 29 publications

Walking Stability During Normal Walking and Its Association with Slip Intensity Among Individuals with Incomplete Spinal Cord Injury

Walking Stability During Normal Walking and Its Association with Slip Intensity Among Individuals with Incomplete Spinal Cord Injury

Factors that influence the risk of falling after spinal cord injury: a qualitative photo-elicitation study with individuals that use a wheelchair as their primary means of mobility

Current state of fall prevention and management policies and procedures in Canadian spinal cord injury rehabilitation

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