Falls in independent ambulatory patients with spinal cord injury: incidence, associated factors and levels of ability

Abstract

Study design: A 6-month retrospective study.

Objectives: To investigate incidence and factors associated with falls in independent ambulatory patients with spinal cord injury (SCI), and to compare levels of ability in those with and without a history of falls.

Setting: A tertiary rehabilitation center and community hospitals.

Methods: Seventy-seven independent ambulatory subjects with SCI were interviewed for fall data during 6 months before participation in the study. Subjects were also assessed for their functional ability using the timed up and go test (TUGT) and the 6-min walk test (6MinWT).

Results: Twenty-six subjects (34%) reported falls during 6 months (range 1-6 times). After falls, two subjects required medical attention due to wrist joint fracture and back pain. Walking without a walking device significantly increased the risk of fall, whereas using a walker significantly reduced the risk of fall (P<0.05). Moreover, faller subjects showed significantly better levels of ability than the non-faller subjects (P<0.005 for the TUGT and P<0.05 for the 6MinWT).

Conclusion: Approximately one-third of the independent ambulatory subjects with SCI experienced falls. Notably, faller subjects had better functional ability than the non-faller subjects. Thus, apart from emphasizing the ability to walk independently, rehabilitation professionals may need to seek strategies that improve balance and safety.