FALLS AMONGST INPATIENTS WITH SPINAL CORD INJURY

Background: Falls are common occurrences in healthcare institutions. A fall may lead to secondary injuries which may negatively influence the patient’s progress in rehabilitation as well as their functional outcomes. However, research concerning falls inpatients with spinal cord injuries (PWSCI), especially patients in South African rehabilitation settings is lacking.

Purpose:  To determine the factors related to falls in PWSCI undergoing rehabilitation at institutions in the Tshwane Metropolitan area, by correlating variables such as the demographic profile of the participants, the spinal cord injury (SCI) profile of the participants, number of participants who sustained falls during rehabilitation, the fall history of these participants, the participants’ perceived concern for falling and association of the participant profile, number of falls and concern for falling.

Methods: A cross-sectional, correlational study design was conducted. PWSCI were consecutively sampled at three South African government institutions to constitute a sample of convenience. Data was collected using the Spinal Cord Injury-Falls Concern Scale (SCI-FCS) and an adapted version of the Socio-demographic and Injury Profile (SDIP). Data was analyzed using descriptive and inferential statistics. Relationships between variables were investigated using Spearman’s rank coefficient. Differences between groups were tested using Kruskal-Wallis and Wilcoxon. Significant testing was set at p≤0.05.

Results: A total of 40 PWSCI from four rehabilitation centers in Pretoria, South Africa, participated in the study. The ages of participants ranged from 19 years to 65 years with the majority of participants falling within the 30-40 age groups (32.5%). The most common type of SCI was paraplegic (62.5%). The majority of participants (85%) had a mean SCI-FCS score of 37.58 (sd 13.19), indicating a high Concern for falling. Only eight participants (20%) reported sustaining fall/s since their SCI, WITH FOUR OF THEM HAVING SUSTAINED A PREVIOUS FALL. These participants reported a high concern for falling when reaching for high objects and least concern for falling when pushing wheelchair on flat ground. There was no significant difference in average SCI-FCS score between participants that fell and those that did not.

Conclusion(s): Factors related to falls in inpatients with SCI include a history of a previous fall, level of injury and type of injury. Concerns for falling were high in the sample, and related to wheelchair activities and self care ADLs. The sample drawn from four rehabilitation centers was however small for conclusive results.

Implications: Falls are a serious safety issue and must be well-managed. The fact that 20% of the participant’s sustained falls is a concern. Injuries from the falls will result in delayed rehabilitation which will lead to socio-economic consequences. We therefore recommend that future research in this field should include prospective longitudinal studies to identify the risk factors of falls in PWSCI using a valid and reliable tool. In addition, investigate fall prevention strategies for PWSCI in private and public institutions, as well as in the community.

Funding, acknowledgements: None

Keywords: falls, inpatients, xpinal cord injuries

Topic: Neurology: spinal cord injury

Did this work require ethics approval? Yes

Institution: University of Pretoria

Committee: Faculty of Health Sciences Research Ethics Committee

Ethics number: 615/2018