Impact of Falls and Fear of Falling on Participation, Autonomy and Life Satisfaction in the First Year After Spinal Cord Injury.
Katherine Chan, Olinda Habib Perez, Hardeep Singh and 3 others
PMID 36188963WHAT IT FOUND
After discharge, falling alone was not linked to participation or life satisfaction.
Fear of falling was linked to lower indoor, outdoor and family autonomy; falling with fear was linked to poorer social life and lower life satisfaction.
Key findings
01In the first 6 months after discharge, 38.3% of participants fell at least once and 45% reported a fear of falling; falling and fear were not related.
02The main models were not statistically significant overall, but fear of falling was linked to worse indoor autonomy, outdoor autonomy and family role participation.
03Fallers with fear had worse participation across autonomy indoors/outdoors, family role and social relationships; life satisfaction was higher for non-fallers with or without fear and fallers without fear.
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
This was an observational study, so it can show associations but cannot prove that fear of falling caused lower participation or that falls caused problems. The sample was analysed as 60 people after 11 were lost to follow-up, which was more than the 10% the team planned for. The study was done at one inpatient rehabilitation centre and included mainly people with motor incomplete spinal cord injury, so it may not apply to all people with spinal cord injury. The main models that tested fall status and fear status together were not statistically significant, so the subscale findings should be read cautiously. The paid work and education participation domain was excluded because many participants said it did not apply, so work or education participation was not assessed. Depression and anxiety were not measured, although they may be linked to fear of falling. Fear of falling was assessed with a single question rather than a detailed validated instrument.
Declared interests
Financial support came from the Canadian Institutes of Health Research. The authors declared no commercial or financial relationships that could be construed as a conflict of interest.
The easy way to misread this
Do not conclude that treating fear of falling will improve participation. This was an observational study, and the overall models with fall and fear status were not statistically significant; the findings are associations, not proven effects.