Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: A mixed methods approach using photovoice

Abstract

Introduction Wheelchair users with spinal cord injury are at a high risk of falls. However, the perspectives of wheelchair users with spinal cord injury on their fall circumstances and their preferences for fall prevention strategies/interventions remain understudied. Therefore, we aimed to: a) describe the circumstances of falls experienced by wheelchair users with spinal cord injury over a six-month period, b) explore their perspectives of why falls occurred in certain situations, and c) explore their perspectives on recommended content/structure of fall prevention strategies/interventions. Methods This sequential explanatory mixed methods study had two phases. Phase I involved tracking of falls experienced by wheelchair users with spinal cord injury over six months, in which participants completed a survey after experiencing a fall to track the number/circumstance of each fall. Data from the surveys were descriptively reported. Phase II involved a photovoice focus group discussion of the survey findings and their preferences for fall prevention strategies/interventions. Data from the focus group discussion were analyzed using a thematic analysis. Results Thirty-two participants completed phase I. More than half of the participants fell at least once in six months. Falls commonly occurred in the afternoon during a transfer, or when participants were wheeling over uneven ground. One-third of the falls caused an injury. Eleven

Evaluating Intrinsic Fall Risk Factors After Incomplete Spinal Cord Injury: Distinguishing Fallers From Nonfallers

“…These findings are consistent with previous studies examining the circumstances of falls among ambulators and wheelchair users with SCI/D. 5 , 12 , 28 , 41 Individuals with SCI/D have explained that home is a “safe space” where they are less vigilant about preventing falls. 41 Further, higher activity levels during the daytime may explain the high fall occurrence in the morning and afternoon.…”

“… 5 , 12 , 28 , 41 Individuals with SCI/D have explained that home is a “safe space” where they are less vigilant about preventing falls. 41 Further, higher activity levels during the daytime may explain the high fall occurrence in the morning and afternoon. 41 Consistent with prior research, 5 , 28 walking was the most commonly performed activity at the time of a fall.…”

“… 41 Further, higher activity levels during the daytime may explain the high fall occurrence in the morning and afternoon. 41 Consistent with prior research, 5 , 28 walking was the most commonly performed activity at the time of a fall. This finding is not surprising because human walking is “a particularly challenging balance task.” 42 (p205)…”

Mortality and risk factors associated with pulmonary embolism in coronavirus disease 2019 patients: a systematic review and meta-analysis

“…Of the remaining 147 articles for full-text review, 131 were excluded because of their natures of case series (n = 9) or review article (n = 1), no information on outcomes (n = 35), content not related to the present study (n = 52), recruitment of only DVT patients (n = 29), mixed thromboembolic events (n = 4), and the use of extracorporeal membrane oxygenation (ECMO) in some patients (n = 1). Finally, a total of 16 studies with 5826 patients were included in the current meta-analysis 20 – 34 (Fig. 1 ).…”

The Effect of Perturbation-Based Balance Training and Conventional Intensive Balance Training on Reactive Stepping Ability in Individuals With Incomplete Spinal Cord Injury or Disease: A Randomized Clinical Trial

“…Participants were as likely to fall during standing as during walking, which is different than in previously reported studies, where more falls in people with iSCI/D occur while walking ( 57 – 59 ). However, the participants in these studies were all full-time ambulators, while some participants in our study used a wheelchair as their primary means of mobility, and previous research has shown that walking is not commonly associated with falls for this group ( 60 ). It is likely that our findings reflect the common activities associated with falls for both ambulators and wheelchair users.…”