High incidence of falls and fall-related injuries in wheelchair users with spinal cord injury: A prospective study of risk indicators

Forslund, Emelie Butler; Jørgensen, Vivien; Franzén, Erika; Opheim, Arve; Seiger, Åke; Ståhle, Agneta; Hultling, Claes; Stanghelle, Johan Kvalvik; Roaldsen, Kirsti Skavberg; Wahman, Kerstin

doi:10.2340/16501977-2177

Cited by 47 publications

(51 citation statements)

References 27 publications

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“…The present study included individuals with motor incomplete SCI only; thus, the findings cannot be generalized to individuals with motor complete SCI (i.e., AIS A and B injuries). As falls are also a frequent event for individuals with motor complete SCI (i.e., 64% will fall in a given year [35]), future work should explore the perceptions and experiences of these individuals to enable development of person-centered fall prevention initiatives.…”

Section: Discussionmentioning

confidence: 99%

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

Musselman

Arnold

Pujol

et al. 2018

Spinal Cord Ser Cases

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Section: Discussionmentioning

confidence: 99%

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

Musselman

Arnold

Pujol

et al. 2018

Spinal Cord Ser Cases

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“…Moreover, these two sports had a combined high incidence rate of acute injuries, that accounted for 70% of the total injuries in the Paralympic Games 6. Wheelchair users with traumatic spinal cord injuries are most prone to falls while playing wheelchair sports, with injuries occurring once every four times 15. Hollander et al reported that 9 out of 100 injuries, which occurred during the WB World Championships 2018 were traumatic injuries due to falls 16.…”

Section: Introductionmentioning

confidence: 99%

Analysis of team-sport wheelchair falls during the Rio 2016 Summer Paralympic Games: a video-based cross-sectional observational study

et al. 2020

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ObjectivesTo present the fall characteristics of athletes playing wheelchair rugby (WR) and wheelchair basketball (WB) using official videos from the Rio 2016 Paralympic Games and compare the key fall characteristics among the team wheelchair sports event.MethodsEighteen WR and 10 WB game videos for men (MWB) and women (WWB), including 8 teams per sport, were obtained from the official International Paralympic Committee of the Rio 2016 Paralympic Games. The videos were analysed to assess the number of falls, playing time of fall, playing phase, contact with other athletes, the direction of the fall and the body part first in contact with the floor during the fall.ResultsIn total, 359 falls (96 for WR, 172 for MWB and 91 for WWB) occurred with a mean of 5.3, 17.2 and 9.1 falls per match, respectively (p<0.05). Significant differences among the three sports were detected in the playing time (p=0.011), presence of contact (p=0.037), direction (p<0.001) and body part first in contact with the floor (p<0.001). For WR, the falls were primarily lateral and caused by contact, occurring in the second half of the match. WB falls tended to be in the first half for women and the second half for men. Most falls were contact falls in the forward direction.ConclusionBy observing the situational details, we described that a number of falls due to contact occurred during these team sports events, especially MWB. In addition, each sport exhibited characteristics attributable to differences in gender, degree of impairment and game rules. The directions of the falls and characteristics of the affected body parts indicate differences in impairments depending on the sport. A fall to the side or back may indicate a risk of injury.

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“…Some (3,5,21), but not all BWSLT studies (7), show improved balance. Falls and fall-related injuries are well-known complications after SCI (28), and improvement gained in truncus stability and balance after BWLT could contribute to the prevention of such events.…”

Section: Improvements In Secondary Outcomesmentioning

confidence: 99%

Manually assisted body-weight supported locomotor training does not re-establish walking in non-walking subjects with chronic incomplete spinal cord injury: A randomized clinical trial

Piira¹,

Lannem²,

Sørensen³

et al. 2019

J Rehabil Med

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LAY ABSTRACTThis randomized clinical trial assesses the effects of manually assisted body-weight supported treadmill training in patients with chronic functionally incomplete spinal cord injury acquired > 2 years earlier. Due to recruitment challenges, it was only possible to recruit twothirds of the planned number of study participants. The intervention group received gait training 5 days per week over 12 weeks, and the control group received usual care with their local physical therapist. Subjects with no baseline gait function did not regain walking ability. Compared with the control group, the intervention group showed modest improvements in walking speed, lower extremity strength, and body control. However, all between-group differences were non-significant. Because the target number of study participants was not reached, the study was underpowered and non-significant, and thus the findings are inconclusive. It does, however, seem that this training method has benefits, but it is labour-intensive and requires large amounts of human resources. Objective: To assess the effects of manually assisted body-weight supported locomotor training in subjects with chronic incomplete spinal cord injury. Design: Randomized controlled clinical trial. Subjects: Twenty subjects with American Spinal Injury Association Impairment Scale grades C or D and > 2 years post-injury. Methods: Random allocation to 60 days of bodyweight supported locomotor training, or usual care, which might include over-ground walking. Walking function, lower extremity muscle strength and balance were blindly evaluated pre-/post-intervention. Results: A small, non-significant improvement in walking function was observed (0.1 m/s (95% confidence interval ( 95% CI) -0.2, 0.4)), but subjects without baseline gait function, did not re-establish walking. The effect on lower extremity muscle strength was 2.7 points (95% CI -1.4, 6.8). No difference was observed in balance measures. Conclusion: Subjects with chronic incomplete spinal cord injury without baseline walking function were unable to re-establish gait with manually assisted body-weight supported locomotor training. A modest, non-significant, improvement was found in strength and walking speed. However, due to study recruitment problems, an effect size that was smaller than anticipated, and large functional heterogeneity among study subjects, the effect of late-onset body-weight supported locomotor training is not clear. Future studies should include larger numbers of subjects with less functional loss and greater functional homogeneity. Intensive training should probably start earlier post-injury.

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High incidence of falls and fall-related injuries in wheelchair users with spinal cord injury: A prospective study of risk indicators

Abstract: 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.

Cited by 47 publications

References 27 publications

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

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

Analysis of team-sport wheelchair falls during the Rio 2016 Summer Paralympic Games: a video-based cross-sectional observational study

Manually assisted body-weight supported locomotor training does not re-establish walking in non-walking subjects with chronic incomplete spinal cord injury: A randomized clinical trial

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