Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study.
What is the 1-year incidence of falls and injurious falls in a representative cohort of community-dwelling ambulatory individuals with chronic spinal cord injury? What are the predictors of recurrent falls (more than two/year) and injurious falls in this population?



One-year longitudinal observational multi-centre study.



A representative sample of 68 (of 73 included) community-dwelling ambulatory individuals with traumatic SCI attending regular follow-up programs at rehabilitation centres.



Primary outcome measures were incidence and predictors of recurrent falls (more than two/year) and injurious falls reported every 2 weeks for 1year.



A total of 48% of participants reported recurrent falls. Of the 272 reported falls, 41% were injurious. Serious injuries were experienced by 4% of participants, all of whom were women. Multivariate logistic regression analysis showed that recurrent falls in the previous year (OR=111, 95% CI=8.6 to 1425), fear of falling (OR=6.1, 95% CI=1.43 to 26) and longer time taken to walk 10m (OR=1.3, 95% CI=1.0 to 1.7) were predictors of recurrent falls. Fear of falling (OR=4.3, 95% CI=1.3 to 14) and recurrent falls in the previous year (OR=4.2, 95% CI=1.2 to 14) were predictors of injurious falls.



Ambulatory individuals have a high risk of falling and of fall-related injuries. Fall history, fear of falling and walking speed could predict recurrent falls and injurious falls. Further studies with larger samples are needed to validate these findings. [Jørgensen V, Butler Forslund E, Opheim A, Franzén E, Wahman K, Hultling C, Seiger Å, Ståhle A, Stanghelle JK, Roaldsen KS (2017) Falls and fear of falling predict future falls and related injuries in ambulatory individuals with spinal cord injury: a longitudinal observational study. Journal of Physiotherapy 63: 108-113].
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
Vivien
V
Jørgensen
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Rehab Station Stockholm/Spinalis R&D Unit.
Emelie
E
Butler Forslund
Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
Arve
A
Opheim
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Physiotherapy, Karolinska University Hospital.
Erika
E
Franzén
Rehab Station Stockholm/Spinalis R&D Unit; Department of Neurobiology, Care Sciences and Society, Division of Neurodegeneration, Karolinska Institutet, Stockholm, Sweden.
Kerstin
K
Wahman
Rehab Station Stockholm/Spinalis R&D Unit; Department of Neurobiology, Care Sciences and Society, Division of Neurodegeneration, Karolinska Institutet, Stockholm, Sweden.
Claes
C
Hultling
Rehab Station Stockholm/Spinalis R&D Unit; Department of Neurobiology, Care Sciences and Society, Division of Neurodegeneration, Karolinska Institutet, Stockholm, Sweden.
Åke
Å
Seiger
Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway; Department of Physiotherapy, Karolinska University Hospital; Department of Neurobiology, Care Sciences and Society, Division of Neurodegeneration, Karolinska Institutet, Stockholm, Sweden.
Agneta
A
Ståhle
Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway; Department of Physical Medicine and Rehabilitation, Faculty of Medicine, University of Oslo, Oslo, Norway.
Johan K
JK
Stanghelle
Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Stockholm, Sweden; Department of Research, Sunnaas Rehabilitation Hospital, Nesodden, Norway.
Kirsti S
KS
Roaldsen
D000058:Accidental Falls / Q000706:statistics & numerical data*; D000203:Activities of Daily Living; D000368:Aged; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D018570:Risk Assessment; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology* / Q000534:rehabilitation*; D016138:Walking
Accidental falls; Fall-related injury; Incidence; Incomplete spinal cord injury; Multivariate logistic regression