Research

Falls in individuals with incomplete spinal cord injury

The purpose of this study was to examine the incidence, circumstances, consequences, and factors associated with falls among a sample of ambulatory person with incomplete SCI. Falls have potentially serious consequences such as heat trauma, tissue damage, fractures, and dislocations. People may also develop a fear of falling which will restrict activity for them. Understanding the consequences and related factors for falling with individuals with incomplete SCI can help health care professionals identify people at risk for falling and implement interventions to prevent falls.

This study took 221 traumatic SCI from outpatient files in a specialty hospital. The participants needed to have a traumatic incomplete SCI, ability to independently ambulate for a minimum of 10 meters with or without assistive devices, be a minimum of one year post SCI, and 18 or older during time of study. The participants completed a questionnaire. A fall was defined as an unplanned, unexpected contact with the supporting surface. The questionnaire consisted of items from the performance based test of the timed up and go, berg balance scale, performance oriented mobility assessment, falls assessment questionnaire and the behavioral risk factor surveillance. The participants were asked to rate items associated with fall on a scale of 1-5 (1 indicated not related to fall, 5 indicating entirely fall related).

The participants were mostly Caucasian male who sustained injury in a motor vehicle. Most participants lived with spouse or other caregiver and reported that they ambulate in the community. Seventy five percent of participants sustained at least one fall over the previous year and the majority was in the home, during the afternoon and evening time. Forty five percent reported that their falls restricted their ability to get out into the community and engage in productive activity. The factors that were perceived to contribute to the falls were decreased strength in trunk and lower extremity, loss of balance, and hazards in the environment.

The study concluded that falls are an important consideration for ambulatory individuals with incomplete SCI in both frequency and the consequences. The incidence of falls was higher among the SCI population than in healthy individuals 65 and older. The incidence of falls was higher in people with incomplete SCI then those with neurological disease such as Parkinson’s disease. Majority of falls occurred in the home with increased fall throughout the day. There was a higher incidence of fractures suggesting a greater consequence among the incomplete SCI population. Half the participants reported that the ability to engage in community and productive activities declined after a fall.

Ambulation is a goal after a SCI and rehabilitation may not always fully address the safety issues involved. In order to better examine the factors that contribute to falls among the population with incomplete SCI thorough assessments need to be implemented.


Brotherton, S. S., Krause J. S., and Nietert, P.J. (2007). Falls in individuals with incomplete spinal cord injury. Spinal Cord, 45, 37-40.