A brief fall prevention intervention for manual wheelchair users with spinal cord injuries: A pilot study
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Objective: To conduct a pilot study of an intervention to decrease fall incidence and concerns about falling among individuals living with Spinal Cord Injury who use manual wheelchairs full-time.
Design: Pre/post. After a baseline assessment, a structured intervention was implemented. The assessment protocol was repeated 12 weeks after the baseline assessment.
Setting: Research laboratory and community.
Participants: 18 individuals living with SCI who use a manual wheelchair full-time with an average age of 35.78 ± 13.89 years, lived with SCI for 17.06 ± 14.6 years; 61.1% were female.
Intervention: A 1:1, 45 minute, in-person intervention focused on factors associated with falls and concerns about falling: transfers skills and seated postural control.
Outcome measures: Participants reported fall incidence and completed the Spinal Cord Injury Fall Concerns Scale, Community Participation Indicators and the World Health Organization Quality of Life – short version (WHOQOL-BREF). Transfer quality was assessed with the Transfer Assessment Instrument (TAI) and seated postural control with the Function In Seating Test (FIST).
Results: Recruitment, assessment and delivery of the intervention were successfully completed. After exposure to the intervention, fall incidence significantly decreased, (P = 0.047, dz = 0.507) and FIST scores improved (P = 0.035, dz = 0.54). Significant improvements were also found in the WHOQOL-BREF Physical (P = 0.05, dz = 1.566) and Psychological (P = 0.040, dz = 0.760) domains.
Conclusion: The feasibility of the structured intervention was established and the intervention has the potential to reduce fall incidence and improve quality of life among individuals living with SCI who use a wheelchair. Appropriately powered randomized controlled trials of the program are warranted.