Ability to detect history of falls among individuals with spinal cord injury using upper limb loading during a seated push-up test

European Journal of Physical and Rehabilitation Medicine, 2022 · DOI: 10.23736/S1973-9087.22.07224-0 · Published: June 1, 2022

Spinal Cord Injury Aging Rehabilitation

Simple Explanation

Individuals with spinal cord injury (SCI) often experience falls, which can lead to injuries. Detecting a history of falls is crucial for preventing future incidents, especially given challenges posed by the COVID-19 pandemic, such as limited hospital access. This study aimed to determine if clinical measures like the handgrip test, Spinal Cord Independence Measure (SCIM) III, and Upper Limb Loading During a Seated Push-Up Test (ULL-SPUT) could differentiate individuals with SCI who had a history of falls from those who did not. The study found that ULL-SPUT data was significantly higher in participants who had a history of falls, suggesting that ULL-SPUT could be used to identify individuals with SCI at a higher risk of falling.

Study Duration

6 Months

Participants

114 wheelchair users and ambulatory individuals with SCI

Evidence Level

Level 3; Retrospective observational cohort study

Key Findings

1
The ULL-SPUT data of faller participants were significantly higher than those of non-fallers (P<0.05).
2
There were no significant differences in demographics, SCI characteristics, or sensorimotor scores between faller and non-faller individuals.
3
The limited rehabilitation length and increased staying home and social isolation prompted by the COVID-19 pandemic may have reduced the fall rates of the participants.

Research Summary

This study explored falls among SCI patients and the ability of three clinical measures, including the HG test, SCIM III and ULL-SPUT, to discriminate between individuals with SCI with and without a history of falls over the past six months. The findings suggest the ability of the ULL-SPUT to discriminate between fallers and non-fallers among individuals with SCI (P<0.05; Table III). The present findings suggest clinical application of a simple measure, namely the ULL-SPUT, which can be obtained using digital bathroom scales placed on a hard and even surface, to discriminate wheelchair users and ambulatory participants with SCI with and without a history of falls.

Practical Implications

Fall Risk Identification

ULL-SPUT can be used to identify individuals with SCI who are at a higher risk of falls.

Fall Prevention Strategies

The ULL-SPUT enables timely initiation of fall prevention strategies in various clinical, community, home and research settings.

Accessibility During Pandemic

The measurement can be done easily using digital bathroom scales, making it practical during the COVID-19 pandemic.

Study Limitations

1
Data collection during the COVID-19 pandemic resulted in a low fall rate (25%), and it was very difficult to recruit additional participants.
2
Retrospective fall data collection may contain recall bias.
3
All participants had good upper limb function (with the levels of the lesions at C8 and below). Such characteristics may limit the generalizability of the findings.

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