Falls and fear of falling predict future falls and related injuries in ambulatory people with spinal cord injury: a longitudinal observational study

Questions: What is the 1-year incidence of falls and injurious falls in a representative cohort of community-dwelling ambulatory people with chronic spinal cord injury? What are the predictors of recurrent falls (more than two/year) and injurious falls in this population? Design: One-year longitudinal observational multi-centre study. Participants: A representative sample of 68 (of 73 included) community-dwelling ambulatory people with traumatic spinal cord injury attending regular follow-up programs at rehabilitation centres. Outcome measures: Primary outcome measures were incidence and predictors of recurrent falls (more than two/ year) and injurious falls reported every 2 weeks for 1 year. Results: A total of 48% of participants reported recurrent falls. Of the 272 reported falls, 41% were injurious. Serious injuries were experienced by 4% of participants, all of whom were women. Multivariate logistic regression analysis showed that recurrent falls in the previous year (OR 111, 95% CI 8.6 to 1425), fear of falling (OR 6.1, 95% CI 1.43 to 26) and longer time taken towalk 10 m(OR 1.3, 95% CI 1.0 to 1.7) were predictors of recurrent falls. Fear of falling (OR 4.3, 95% CI 1.3 to 14) and recurrent falls in the previous year (OR 4.2, 95% CI 1.2 to 14) were predictors of injurious falls. Conclusion: Ambulatory people with a spinal cord injury have a high risk of falling and of fall-related injuries. Fall history, fear of falling and walking speed could predict recurrent falls and injurious falls. Further studies with larger samples are needed to validate these findings. (C) 2017 Australian Physiotherapy Association. Published by Elsevier B.V.