Negotiating identity and self-image: perceptions of falls in ambulatory individuals with spinal cord injury - a qualitative study.
Vivien Jørgensen, Kirsti Skavberg Roaldsen
PMID 27170274WHAT IT FOUND
Ambulatory people with chronic traumatic spinal cord injury described walking as central to feeling normal.
They minimized fall risk through planning, aids and training, but often accepted or exceeded risk to preserve identity, valued activities and daily life.
Key findings
01Walking was of prime importance to participants despite increased fall risk, and falling challenged their identity as normal.
02Participants described immediate strategies such as being careful, avoiding risky situations, screening surfaces and using aids, and longer-term strategies such as strength and balance training.
03Most took calculated risks to live on their own terms, and some went beyond normal calculated risks to achieve higher function or maintain valued activities.
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
The study used a small, purposive sample, so its themes cannot be assumed to apply to all ambulatory people with spinal cord injury. Everyone had experienced a fall in the previous year, so perceptions of people who had not fallen or only had near-falls were not captured. Women were more represented than in the wider Norwegian spinal cord injury population, which may overstate concerns and experiences more common among women. The interviewer was a physiotherapist, and the background questionnaire may have primed participants to think about falls before the interview. The sample included a wide age range, but most participants were younger adults, and much fall research is in older adults, so comparison is limited.
Declared interests
The authors declared no potential conflicts of interest. The work was supported by grants from the Department of Research at Sunnaas Rehabilitation Hospital, Norway.
The easy way to misread this
Do not read these themes as evidence that any fall-prevention strategy works. The study only describes perceptions and risk-taking in a small group of people who had already fallen, so it cannot show whether safer walking choices reduce falls or improve participation.