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

Archives of Rehabilitation Research and Clinical Translation, 2021 · DOI: https://doi.org/10.1016/j.arrct.2020.100096 · Published: January 1, 2021

Spinal Cord Injury Aging Rehabilitation

Simple Explanation

Falls are common after spinal cord injury, especially among those who can still walk. These falls can affect a person's ability to work, care for themselves, and enjoy leisure activities, leading to feelings of frustration and fear. This study aimed to identify specific factors that can help predict who is more likely to fall after a spinal cord injury. The researchers looked at things like lower extremity strength, sensory function, balance, walking speed, and confidence in their balance. The study found that weaker lower extremity strength, reduced cutaneous pressure sensitivity, slower walking speed and increased body sway were associated with a higher risk of falls. These findings can help doctors better assess a patient’s risk of falling.

Study Duration

1 year

Participants

26 individuals with motor incomplete SCI/D

Evidence Level

Prospective cohort study

Key Findings

1
Poorer performance on measures of lower extremity strength was associated with a higher risk of falls among ambulatory individuals with SCI/D.
2
Reduced cutaneous pressure sensitivity in the lower extremities was associated with an increased risk of falls.
3
Slower walking speed and increased mediolateral postural sway were associated with a higher risk of falls.

Research Summary

This prospective cohort study examined the association between falls and various laboratory-based and clinical measures in ambulatory individuals with spinal cord injury or disease (SCI/D). The study found that poorer performance in lower extremity strength, cutaneous pressure sensitivity, walking speed, and mediolateral postural control were associated with a higher risk of falls. These findings suggest that these factors can help identify ambulatory individuals with SCI/D who are at a greater risk of falling, assisting clinicians in evaluating their patients’ fall risk.

Practical Implications

Clinical Assessment

Clinicians should consider lower extremity strength, cutaneous pressure sensitivity, and walking speed when evaluating fall risk in ambulatory SCI/D patients.

Targeted Interventions

Rehabilitation programs should focus on improving lower extremity strength, cutaneous sensation, and walking speed to reduce fall risk.

Environmental Modifications

Address home safety, as most falls occurred at home. Encourage vigilance in familiar environments.

Study Limitations

1
Small sample size
2
Missing laboratory-based data limited statistical analyses
3
The study did not perform a comprehensive assessment of all risk factors associated with falls

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