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

PLoS ONE, 2020 · DOI: https://doi.org/10.1371/journal.pone.0238116 · Published: August 28, 2020

Simple Explanation

This study explores why wheelchair users with spinal cord injuries (SCI) fall and their ideas for preventing falls. It combines surveys to track falls with group discussions to gather detailed insights. The study found that many falls happen at home during transfers or while wheeling over uneven ground. Participants suggested that fall prevention should be personalized and included in rehabilitation programs. Ultimately, the study suggests fall prevention requires a comprehensive approach, integrating tailored strategies and education for both wheelchair users and their caregivers.

Study Duration

6 Months

Participants

32 wheelchair users with spinal cord injury

Evidence Level

Not specified

Key Findings

1
More than half of the participants fell at least once in six months, highlighting the high risk of falls in this population.
2
Falls commonly occurred in the afternoon or evening, either inside or just outside of the home, often during transfers or while wheeling over uneven ground.
3
Participants emphasized the importance of learning how to fall correctly to minimize injury and advocated for safety by addressing community hazards and improving training for accessible vehicle drivers.

Research Summary

This study used a mixed-methods approach to investigate fall circumstances and prevention strategies among wheelchair users with spinal cord injury (SCI). The study found that a significant proportion of participants experienced falls, with common circumstances including transfers and navigating uneven ground. Falls often occurred in the home environment. Participants suggested that fall prevention strategies should be individualized, integrated into rehabilitation practices, and involve education for both wheelchair users and their caregivers. They also emphasized the importance of learning how to fall correctly and advocating for environmental safety.

Practical Implications

Personalized Fall Prevention Programs

Tailor fall prevention programs to the specific needs and circumstances of each wheelchair user, considering their environment, activities, and physical abilities.

Integrated Rehabilitation Practices

Incorporate fall prevention strategies into standard rehabilitation practices, including wheelchair prescription, transfer training, and advanced wheelchair skills training.

Education for Caregivers

Provide education and training to caregivers, family members, and friends on fall prevention techniques and how to assist wheelchair users safely.

Study Limitations

1
The information collected in the surveys and focus group discussion was limited to the questions we had asked.
2
Fall-related injuries in this study were self-reported. Self-reported data can under or over report information
3
The small sample size limits generalizability of the quantitative data.

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