College of Health Professions, Medical University of South Carolina, Charleston, SC, USA.
Spinal Cord. 2021 Jul;59(7):747-752. doi: 10.1038/s41393-020-00572-7. Epub 2020 Oct 31.
Prospective cohort study with two times of measurement.
To assess the relationship between use of assistive devices for walking (at baseline) and the number of annual fall-related injuries (at follow-up) among a cohort of ambulatory adults with spinal cord injury (SCI).
Medical University in the Southeastern United States.
There were 622 ambulatory adults who met the eligibility criteria, 317 of whom completed both baseline and follow-up assessments. The participants completed a mailed self-report assessment (SRA) that measured self-reported number of fall-related injuries in the previous year, and the use of orthopedic equipment (assistive devices) for walking, including cane(s), crutches, walker, and braces, was assessed at both baseline and follow-up.
The percentage of at least one self-reported fall-related injury decreased from 22% at baseline to 13% at the follow-up. Walker and cane use at baseline was significantly associated with fall-related injuries at follow-up. Participants using one walking device related to 194% greater number of fall injures, and using multiple device related to 730% greater number of fall injures than those who used no devices. We also found walker users were associated with 214% greater number of fall injures, while cane users were associated with 160% greater number of fall injures.
The probability of fall-related injury remained high among persons who are ambulatory after SCI. Health care professionals should be aware of the balance between the goal of ambulation and the potential increased risk of fall-related injuries associated with assistive device use.
前瞻性队列研究，两次测量。
评估步行辅助设备（基线时）的使用与脊髓损伤（SCI）患者队列中每年跌倒相关损伤（随访时）的数量之间的关系。
美国东南部的一所医科大学。
有 622 名符合入选标准的活动能力成年人，其中 317 名完成了基线和随访评估。参与者完成了邮寄的自我报告评估（SRA），该评估测量了前一年与跌倒相关的损伤次数，并且在基线和随访时评估了用于行走的矫形设备（辅助设备）的使用情况，包括手杖、拐杖、助行器和支架。
至少有一次自我报告跌倒相关损伤的百分比从基线时的 22%下降到随访时的 13%。基线时使用助行器和手杖与随访时跌倒相关损伤显著相关。与不使用任何设备的人相比，使用一种步行设备与跌倒损伤的发生相关增加了 194%，使用多种设备与跌倒损伤的发生相关增加了 730%。我们还发现，助行器使用者跌倒损伤的发生相关增加了 214%，而手杖使用者跌倒损伤的发生相关增加了 160%。
SCI 后活动能力的人跌倒相关损伤的概率仍然很高。医疗保健专业人员应该意识到在行走目标和与辅助设备使用相关的潜在增加的跌倒相关损伤风险之间的平衡。
