title: A systematic review of risk factors associated with accidental falls, outcome measures and interventions to manage fall risk in non-ambulatory adults.
abstract: OBJECTIVE
  To systematically review peer-reviewed literature pertaining to risk factors, outcome measures and interventions managing fall risk in non-ambulatory adults.
  
  
  METHODS
  Twenty-one papers were selected for inclusion from databases including PubMed/Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, Scopus, Consumer Health Complete and Web of Science. Selected studies involved a description of fall related risk factors, outcomes to assess fall risk and intervention studies describing protocols to manage fall risk in non-ambulatory adults. Studies were selected by two reviewers and consultation provided by a third reviewer.
  
  
  RESULTS
  The most frequently cited risk factors/characteristics associated with falls included: wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. The majority of the outcomes were found to evaluate seated postural control. One intervention study was identified describing a protocol targeting specific problems of individual participants. A global fall prevention program was not identified.
  
  
  CONCLUSIONS
  Several risk factors associated with falls were identified and must be understood by clinicians to better serve their clients. To improve objective assessment, a comprehensive outcome assessment specific to non-ambulatory adults is needed. Finally, additional research is needed to examine the impact of structured protocols to manage fall risk in non-ambulatory adults.
  
  
  CONCLUSIONS
  Falls are a common health concern for non-ambulatory adults. Risk factors commonly associated with falls include wheelchair related characteristics, transfer activities, impaired seated balance and environmental factors. Limited outcome measures are available to assess fall risk in non-ambulatory adults. Clinicians must be aware of the known risk factors and provide comprehensive education to their clients on the potential for falls. Additional research is needed to develop and evaluate protocols to clinically manage fall risk.
authors.affiliation: Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign , Champaign, IL , USA.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Rice
authors.forename: Cherita
authors.initials: C
authors.lastname: Ousley
authors.forename: Jacob J
authors.initials: JJ
authors.lastname: Sosnoff
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control*; D000328:Adult; D019468:Disease Management; D006801:Humans; D004856:Postural Balance; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Fall; mobility limitations; wheelchair