title: Postural control and fear of falling in persons with low-level paraplegia.
abstract: Falls are prevalent reasons for spinal cord injury (SCI). Postinjury fear of falling (FOF) can affect rehabilitation potential. We quantified FOF in 15 men with paraplegia (ambulatory with bilateral knee-ankle-foot orthoses [KAFOs] and elbow crutches) in correlation with their postural control at the center for long-term SCI rehabilitation of a tertiary-care teaching hospital. Our outcome measures comprised the American Spinal Injury Association Impairment Scale, the Modified Falls Efficacy Scale (MFES), postural sway measurements in the anteroposterior and mediolateral directions; and walking speed, cadence, and endurance. We assessed FOF with the MFES followed by measuring postural sway with a force platform. We measured gait parameters by asking the participant to ambulate on an indoor pathway. The mean postural sway was 314.13 +/- 184.05 mm (mean +/- standard deviation) in the anteroposterior direction and 222.16 +/- 112.34 mm in the mediolateral direction. The MFES score was 41.29 +/- 12.77, which showed a statistically significant negative correlation with postural control. The self-perception of confidence as measured by MFES might not really represent the actual postural stability in individuals with low-level paraplegia. FOF can adversely affect the postural control of individuals with low-level paraplegia. Clinicians should consider FOF as an influential factor in postural control during rehabilitation.
authors.affiliation: Physiotherapy Service, Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India.
authors.forename: Ligie T
authors.initials: LT
authors.lastname: John
authors.forename: Binu
authors.initials: B
authors.lastname: Cherian
authors.forename: Andrew
authors.initials: A
authors.lastname: Babu
mesh_terms: D000058:Accidental Falls; D000293:Adolescent; D000328:Adult; D003446:Crutches; D005239:Fear; D006801:Humans; D008297:Male; D009989:Orthotic Devices; D010264:Paraplegia / Q000209:etiology / Q000534:rehabilitation*; D004856:Postural Balance; D020377:Self Efficacy; D013119:Spinal Cord Injuries / Q000150:complications / Q000534:rehabilitation*; D055815:Young Adult