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

Abstract

Study design: Exploratory qualitative study using photo-elicitation interviews.

Objectives: To identify contributors to falls, as perceived by individuals with incomplete spinal cord injury, and describe the impact of perceived fall risk on mobility and physical activity.

Setting: Participants' home and community environments.

Methods: Eight individuals with chronic motor incomplete spinal cord injury participated. Participants took photographs of situations that increased/decreased their risk of falling, or depicted how this risk impacted mobility and physical activity. Photographs were discussed in semi-structured interviews. Inductive thematic analysis was used to describe participants' perceptions and experiences.

Results: Photo-elicitation interviews identified four themes: (1) Perceived challenges were primarily environmental with biological (e.g., reduced strength) and behavioral (e.g., risk-taking) factors also identified. (2) Impact of perceived fall risk included moving slowly, avoiding balance-provoking activities, and feelings of frustration and/or fear. (3) Prevent falls: learn through experience included strategies used to avoid falls, which were learnt experientially and consisted of changes to behavior. (4) Factors mitigating impact of perceived fall risk included character traits (i.e., perseverance, optimism) and a desire for independence.

Conclusions: Primarily environmental factors were perceived to contribute to fall risk and mainly behavioral strategies were adopted to mitigate the risk.

Sponsorship: Physiotherapy Foundation of Canada.

Fig. 1

Photographs depicting the perceived challenges that increase fall risk

Fig. 2

Photographs depicting the perceived impact of fall risk on participants’ mobility and physical activity