Citation

Musselman KE, Arora T, Chan K, Alavinia M, Bone M, Unger J, Lanovaz J, Oates A. Arch. Rehabil. Res. Clin. Transl. 2021; 3(1): e100096.

Copyright

(Copyright © 2021, Elsevier Publishing)

DOI

10.1016/j.arrct.2020.100096

PMID

33778471

Abstract

OBJECTIVE: To determine whether performance on measures of lower extremity muscle strength, sensory function, postural control, gait speed, and balance self-efficacy could distinguish fallers from nonfallers among ambulatory individuals with spinal cord injury or disease (SCI/D).

DESIGN: Prospective cohort study. SETTING: Community. PARTICIPANTS: Individuals (N=26; 6 female, aged 58.9±18.2y) with motor incomplete SCI/D (American Spinal Injury Association Impairment Scale rating C [n=5] or D [n=21]) participated. Participants were 7.5±9.1 years post injury. Seventeen participants experienced traumatic causes of spinal cord injury. MAIN OUTCOME MEASURES: Participants completed laboratory-based and clinical measures of postural control, gait speed, balance self-efficacy, and lower extremity strength, as well as proprioception and cutaneous pressure sensitivity. Participants were then followed for up to 1 year to track falls using a survey. The survey queried the circumstances and consequences of each fall. If a participant's number of falls equaled or exceeded the median number of falls experience by all participants, they were classified a faller.

RESULTS: Median follow-up duration was 362 days and median time to first fall was 60.5 days. Fifteen participants were classified as fallers. Most falls occurred during the morning or afternoon (81%), at home (75%), and while walking (47%). The following laboratory-based and clinical measures distinguished fallers from nonfallers (P<.05): measures of lower extremity strength, cutaneous pressure sensitivity, walking speed, and center of pressure velocity in the mediolateral direction.

CONCLUSIONS: There are laboratory-based and clinical measures that can prospectively distinguish fallers from nonfallers among ambulatory individuals with spinal cord injury. These findings may assist clinicians when evaluating their patients' fall risk.

Language: en

Keywords

Falls; Accidental falls; Walking; Rehabilitation; Spinal cord injuries; 10MWT, 10-m walk test; ABC, Activities-specific Balance Confidence; Ambulation; AP, anteroposterior; COP, center of pressure; EC, eyes closed; EO, eyes open; IQR, interquartile range; ML, mediolateral; SCI/D, spinal cord injury or disease