Risk of Fall-Related Injuries among Ambulatory Participants with Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2013 · DOI: 10.1310/sci1904-259 · Published: January 1, 2013

Spinal Cord Injury Trauma Rehabilitation

Simple Explanation

This study looks at the risk of falls that result in injury among people with spinal cord injuries who are able to walk. It explores how walking aids, alcohol and medication use, and exercise habits might affect their risk of falling. The study found that people who use a wheelchair more often than they walk are less likely to have fall-related injuries. Also, those who feel they have poor balance or get less exercise are more prone to injuries from falls. Misuse of pain medication was also linked to a higher risk of fall-related injuries. Therefore, doctors should consider a person's walking ability, medication use, and exercise habits when recommending walking techniques.

Study Duration

Not specified

Participants

515 adults with chronic SCI who were able to ambulate

Evidence Level

Not specified

Key Findings

1
Ambulatory participants using a wheelchair as their primary mobility mode had fewer fall-related injuries compared to those who walked more.
2
Participants with perceived poor balance were more than twice as likely to experience fall-related injuries.
3
Reduced exercise levels and pain medication misuse significantly increased the likelihood of fall-related injuries among ambulatory SCI participants.

Research Summary

This study assessed the relationships between walking devices and behaviors, including alcohol use, prescription medication use, and exercise, with FRI among participants with SCI who are ambulatory. The study found that ambulatory participants who reported using a wheelchair as their primary mode of mobility were less likely to have an FRI than those who reported walking more than using a wheelchair. Health care providers should be aware of the risk for FRI among those who are ambulatory and should consider behaviors, including prescription medication use and exercise, when recommending ambulation techniques.

Practical Implications

Bilateral Support Consideration

The elevated risk of FRI associated with unilateral cane and crutch use suggests the need for consideration of bilateral supports.

Pain Medication Management

Caution is needed when prescribing medications to ambulatory individuals, with focus on alternative pain management and rehabilitation programs.

Interdisciplinary Approach

The relationship among pain medication abuse, ambulation, and FRI risk demonstrates the importance of an interdisciplinary approach with goals defined based on ambulatory ability and risk of adverse outcomes.

Study Limitations

1
All data are self-report, subject to recall bias.
2
The study only focused on FRI, so results cannot be directly compared to studies focusing on all falls.
3
Participants were identified through the same facility in the southeastern United States, thus results may not be fully generalizable to other regions.

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