J. Wannapakhe, PT, PhD, School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
Phys Ther. 2014 May;94(5):675-81. doi: 10.2522/ptj.20130260. Epub 2014 Mar 6.
Ambulatory patients with spinal cord injury (SCI) encounter a high risk of falls. However, most of the fall data in the literature were subjectively reported, without evidence to confirm the functional ability of those with and without falls.
The purpose of this study was to prospectively evaluate changes in functional ability relating to falls in participants with SCI who fell and those who did not fall during the 6-month period after discharge.
A 6-month prospective design was used in the study.
Fifty independent ambulatory participants with SCI were assessed for their functional ability using the Timed "Up & Go" Test, 10-Meter Walk Test, Berg Balance Scale, and Six-Minute Walk Test (6MWT) prior to discharge and 6 months afterward. After discharge, the participants' fall data were monitored monthly to categorize them into faller (≥1 fall in 6 months) and nonfaller (no fall) groups.
Twenty-seven participants (54%) fell, and their baseline functional abilities were obviously lower than those who did not fall. After 6 months, the functional ability of these participants showed significant improvement for every test, whereas those who did not fall demonstrated a significant improvement only for the 6MWT. After adjusting for the baseline data, the functional ability at 6 months showed no significant differences between the groups.
The study did not monitor physical activities of the participants during the follow-up period. The findings on fear of falling were subjectively reported by the participants.
Participants with SCI are commonly characterized as being active and enthusiastic, which may drive their physical activities. However, sensorimotor impairments following SCI hinder their ability to move safely, particularly in those with more functional deterioration. Therefore, greater functional improvement is accompanied by a higher risk of falls. Because falls can induce serious consequences, rehabilitation professionals may need to seek strategies to improve safety issues during movement for these patients, particularly in their own environments.
脊髓损伤（SCI）的门诊患者有很高的跌倒风险。然而，文献中的大多数跌倒数据都是主观报告的，没有证据可以证实有跌倒和无跌倒的患者的功能能力。
本研究旨在前瞻性评估 SCI 患者在出院后 6 个月内跌倒和未跌倒的参与者的功能能力变化。
本研究采用 6 个月的前瞻性设计。
50 名独立的 SCI 门诊患者在出院前和 6 个月后分别使用计时“站起和行走”测试、10 米步行测试、伯格平衡量表和 6 分钟步行测试（6MWT）评估其功能能力。出院后，每月监测参与者的跌倒数据，将其分为跌倒者（6 个月内跌倒≥1 次）和非跌倒者（无跌倒）。
27 名参与者（54%）跌倒，他们的基线功能能力明显低于未跌倒者。6 个月后，这些参与者的各项功能能力均显著提高，而未跌倒者仅在 6MWT 上表现出显著提高。调整基线数据后，两组间 6 个月时的功能能力无显著差异。
本研究在随访期间没有监测参与者的身体活动。对跌倒恐惧的发现是由参与者主观报告的。
SCI 患者通常表现出活跃和热情，这可能促使他们进行身体活动。然而，SCI 后的感觉运动障碍会阻碍他们安全移动的能力，尤其是在功能恶化更严重的患者中。因此，更大的功能改善伴随着更高的跌倒风险。由于跌倒可能导致严重后果，康复专业人员可能需要寻求策略来改善这些患者在自身环境中运动时的安全问题。
