School of Physical Therapy, Faculty of Associated Medical Sciences, and Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.
Phys Ther. 2013 Aug;93(8):1061-72. doi: 10.2522/ptj.20120467. Epub 2013 Apr 18.
Sensorimotor impairments following spinal cord injury (SCI) affect mobility and subsequently increase the risk of falls to patients. However, most of the fall data for these patients were retrospectively gathered.
This study prospectively assessed falls and intrinsic factors associated with falls in 89 independent ambulatory individuals with SCI over the course of 6 months. In addition, functional ability between participants who did and did not fall was compared.
Participants were interviewed and assessed for their baseline data and functional ability using the Timed "Up & Go" Test and the Six-Minute Walk Test. Then they were interviewed by telephone to complete a self-report questionnaire once per week to gather fall data for 6 months. A stepwise multiple logistic regression was utilized to determine the effects of demographics and SCI characteristics on occurrence of falls. The functional data between participants who fell and those who did not fall were compared using the Mann-Whitney U test.
Thirty-five participants (39%) experienced at least 1 fall during 6 months (range=1-11). Two participants required medical attention due to patellar and sternum fractures after falling. Participants with an educational level of high school graduate or greater, an American Spinal Injury Association Impairment Scale C (AIS-C) classification, and a fear of falling (FOF) significantly increased their risk of falls approximately 4 times more than those who graduated primary education, had an AIS-D classification, and did not have FOF. Moreover, the functional abilities of participants who fell were significantly poorer than those who did not fall.
The sample size was calculated based on the primary objective (incidence of falls), which may not be sufficient to clearly indicate factors associated with falls for the participants.
More than one third of the independent ambulatory participants with SCI experienced at least 1 fall during the 6-month period of the study. The findings suggest the importance of functional improvement on the reduction of fall risk in these individuals.
脊髓损伤（SCI）后感觉运动障碍会影响活动能力，从而增加患者跌倒的风险。然而，大多数关于这些患者跌倒的数据都是回顾性收集的。
本研究前瞻性评估了 89 名独立行走的 SCI 患者在 6 个月内的跌倒情况和与跌倒相关的内在因素。此外，比较了跌倒组和未跌倒组患者的功能能力。
参与者接受了访谈，并使用计时“起立行走”测试和 6 分钟步行测试评估了他们的基线数据和功能能力。然后，他们通过电话接受了每周一次的自我报告问卷调查，以收集 6 个月的跌倒数据。采用逐步多因素逻辑回归分析确定人口统计学和 SCI 特征对跌倒发生的影响。使用 Mann-Whitney U 检验比较了跌倒组和未跌倒组患者的功能数据。
35 名参与者（39%）在 6 个月内至少经历了 1 次跌倒（范围 1-11 次）。有 2 名参与者因跌倒后髌骨和胸骨骨折需要就医。与仅接受过小学教育、AIS-D 分级和无跌倒恐惧的参与者相比，具有高中及以上学历、AIS-C 分级和有跌倒恐惧的参与者发生跌倒的风险增加了约 4 倍。此外，跌倒组患者的功能能力明显差于未跌倒组患者。
样本量是根据主要目标（跌倒发生率）计算的，这可能不足以明确指出参与者跌倒的相关因素。
超过三分之一的独立行走的 SCI 患者在研究的 6 个月期间至少经历了 1 次跌倒。研究结果表明，改善功能对于降低这些患者跌倒风险的重要性。
