Evaluating Intrinsic Fall Risk Factors After Incomplete Spinal Cord Injury: Distinguishing Fallers From Nonfallers.
Kristin E Musselman, Tarun Arora, Katherine Chan and 5 others
PMID 33778471WHAT IT FOUND
Slower walking, weaker legs, poor foot sensation, and side-to-side sway when eyes are closed were linked to more falls in people with incomplete spinal cord injury.
These factors help flag risk, but no single test predicts falls reliably.
Key findings
01Poorer lower extremity strength and cutaneous pressure sensation were associated with a higher number of falls.
02Faster self-selected and fast walking speeds were associated with fewer falls, but walking speed reserve was not.
03Increased center of pressure sway in the mediolateral direction (side-to-side) when eyes were closed compared to open was associated with more falls.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Very small sample size (26 participants), which limits statistical power and prevents multivariate analysis. Missing balance data for 6 participants reduced the sample for those specific analyses. The study only looked at intrinsic factors (body-based), ignoring environmental or behavioral causes of falls. The definition of 'faller' was based on the median number of falls in this specific group, which may not generalize to other populations. Simple proprioception testing may have lacked the sensitivity to detect deficits related to falls.
Declared interests
The authors declare no conflicts of interest. The study was supported by grants from the Saskatchewan Health Research Foundation and the Canadian Institutes of Health Research.
The easy way to misread this
Do not assume that a patient's reported confidence in their balance (ABC Scale) predicts their fall risk. In this study, balance confidence did not distinguish fallers from non-fallers, whereas physical measures like strength and walking speed did.