Perceived Cause, Environmental Factors, and Consequences of Falls in Adults with Cerebral Palsy: A Preliminary Mixed Methods Study

Abstract

Objective. Describe perceived cause, environmental influences, and consequences of falls or near-falls in ambulant adults with cerebral palsy (CP). Methods. Adults with CP completed postal surveys and follow-up semistructured interviews. Surveys sought information on demographic data, self-nominated Gross Motor Function Classification Score (GMFCS-E&R), falls, and near-falls. Interviews gathered additional information on falls experiences, near-falls, and physical and psychosocial consequences. Results. Thirty-four adults with CP participated. Thirty-three participants reported at least one fall in the previous year. Twenty-six participants reported near-falls. Most commonly, falls occurred indoors, at home, and whilst engaged in nonhazardous ambulation. Adults with CP experienced adverse falls consequences, lower limb injuries predominant (37%), and descriptions of fear, embarrassment, powerlessness, and isolation. Discussion. Adults with CP may experience injurious falls. Further investigation into the impact of falls on health-related quality of life and effective remediation strategies is warranted to provide comprehensive falls prevention programs for this population.

Profile of hospital admissions for adults with cerebral palsy: a retrospective cohort study

“…Although falls data was not specifically extracted, 19 adult admissions that had a primary admission coded as injury had the secondary admission coded as a fall. The impact of an injurious fall in an adult with CP on hospital admission LOS and ongoing need for rehabilitation and support is undocumented, although prior observational studies have suggested falls consequences in this population result in a serious and significant burden 20,21 . Given the potential to tackle this issue within primary care services, and thus reduce acute hospital burden, this requires further exploration.…”

Falls in paediatric Charcot-Marie-Tooth disease: a 6-month prospective cohort study

“…Younger children with CMT were likely to experience more than two falls per day, with less frequent falls in older children. Adolescents with CMT may be more aware of situations or activities where they fall and avoid these, a perspective reported by young adults with cerebral palsy 24. Reduced balance confidence has been shown to be associated with increased falls and functional gait limitations,25 and falls risk and fear of falling were perceived barriers to physical activity in adults with CMT 26.…”

“…The absence of a relationship between disease severity and falls may reflect the composite scoring of the CMTPedS, which records upper and lower limb components, or the small sample. Alternatively, it may be that more severely affected children move less, perhaps self-limiting activity and therefore reducing the risk of falling, as seen in young adults with cerebral palsy 24…”

‘Have you ever talked to any women with Turner syndrome?’ Using universal design and photo elicitation interviews in research with women with mild cognitive impairment

“…Yet, these adaptions are not always described explicitly. A recent interview study with people with cerebral palsy (Morgan et al, 2015) did not mention any adaptions that may have been used to accommodate related mobility and communication issues, so the researchers' approach to this is not clear. In the case of TS, there is little research that describes the use of adaptions to increase their comfort and participation in research interviews, even though, as I describe in the 'The need for adaptions' section, this could potentially benefit some women.…”