Fall Prevalence and Contributors to the Likelihood of Falling in Persons With Upper Limb Loss.
Matthew J Major
PMID 30561742WHAT IT FOUND
Among 105 people with upper limb loss who answered fall questions, 28.6% reported two or more falls in the past year and 45.7% reported at least one.
Lower balance confidence, low perceived capability, and prosthesis use were associated with frequent falls.
Key findings
01Among 105 people who answered fall questions, 28.6% reported two or more falls in the past year and 45.7% reported at least one.
02In the final model, lower balance confidence, use of an upper limb prosthesis, and low perceived physical capabilities were associated with higher likelihood of being classified as a faller.
03Among 41 people who reported falls and answered injury questions, 31.7% said their most recent fall caused injury and 14.6% needed medical attention or a hospital visit.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The survey was online and anonymous, so it could only reach people with computer access and may have over-represented younger people and those with unilateral upper limb loss. Falls were recalled over the past 12 months, and only the most recent fall was described in detail, so fall circumstances may be incomplete or biased. The final regression used 84 of the 109 respondents, and many variables were self-reported, including balance confidence and physical capability. This was a cross-sectional survey, so it cannot show that prosthesis use, low balance confidence, or low perceived capability caused falls. The Activities-specific Balance Confidence scale was not established as a screening cut-off for this group, and the authors caution further psychometric evaluation before using it that way. Participants were on average many years since limb loss, which may mask effects of time since loss.
Declared interests
The US Department of Veterans Affairs supported the study through a Career Development Award, and Northwestern University funded hosting of the online survey. Authors completed a disclosure form and reported no conflicts of interest.
The easy way to misread this
Do not conclude that upper limb prostheses cause falls or should be withheld. This was a cross-sectional survey, so prosthesis use was associated with frequent falls but not proven to cause them, and the paper explicitly says there are no ethical grounds to deny a prosthesis based on these results.