Abstract
Study design
Prospective cohort study with two times of measurement.
Objective
To assess the relationship between use of assistive devices for walking (at baseline) and the number of annual fall-related injuries (at follow-up) among a cohort of ambulatory adults with spinal cord injury (SCI).
Setting
Medical University in the Southeastern United States.
Methods
There were 622 ambulatory adults who met the eligibility criteria, 317 of whom completed both baseline and follow-up assessments. The participants completed a mailed self-report assessment (SRA) that measured self-reported number of fall-related injuries in the previous year, and the use of orthopedic equipment (assistive devices) for walking, including cane(s), crutches, walker, and braces, was assessed at both baseline and follow-up.
Results
The percentage of at least one self-reported fall-related injury decreased from 22% at baseline to 13% at the follow-up. Walker and cane use at baseline was significantly associated with fall-related injuries at follow-up. Participants using one walking device related to 194% greater number of fall injures, and using multiple device related to 730% greater number of fall injures than those who used no devices. We also found walker users were associated with 214% greater number of fall injures, while cane users were associated with 160% greater number of fall injures.
Conclusions
The probability of fall-related injury remained high among persons who are ambulatory after SCI. Health care professionals should be aware of the balance between the goal of ambulation and the potential increased risk of fall-related injuries associated with assistive device use.
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Data availability
The data sets generated and/or analyzed during the current study are not publicly available due to the privacy concerns of study participants and are not standardized to be in a publicly interpretable format.
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Funding
The contents of this publication were developed under grants from the South Carolina Spinal Cord Injury Research Fund (SCSCIRF) grants SCIRF 2017 SI-02, SCIRF 09–001, and from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) grant 90RT5003. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of the SCSCIRF, NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government or the state of South Carolina.
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YC was the principal investigator and was responsible for the analyses, research methods and results sections, and contributed to the discussion and conclusion sections. NDD was responsible for the introduction and literature review, as well as contributing to the discussion and conclusion sections. SSB contributed to the introduction, discussion, and conclusion sections. JSK was responsible for the discussion and conclusion sections, and contributed to the overall development and editing of the paper.
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Cao, Y., DiPiro, N.D., Brotherton, S.S. et al. Assistive devices and future fall-related injuries among ambulatory adults with spinal cord injury: a prospective cohort study. Spinal Cord 59, 747–752 (2021). https://doi.org/10.1038/s41393-020-00572-7
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DOI: https://doi.org/10.1038/s41393-020-00572-7
