Chan Katherine, Habib Perez Olinda, Singh Hardeep, Marinho-Buzelli Andresa R, Hitzig Sander L, Musselman Kristin E
KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Front Rehabil Sci. 2022 Jun 9;3:903097. doi: 10.3389/fresc.2022.903097. eCollection 2022.
Individuals with spinal cord injury (SCI) experience reduced participation in meaningful activities, leading to reduced social engagement and negative psychological impact. Two factors that may affect participation post-SCI are fall status (e.g., having experienced a fall) and having a fear of falling. Our objective was to examine if and how fall status and fear of falling impact participation, autonomy and life satisfaction in the first year post-injury.
Adult inpatients of a SCI rehabilitation hospital were recruited. Following discharge, falls were tracked for 6 months and participants who fell at least once were categorized as "fallers". At the end of the 6-month period, the Impact on Participation and Autonomy Questionnaire and Life Satisfaction Questionnaire 9 were administered, and participants were asked if they had a fear of falling (i.e., an ongoing concern about falling leading to the avoidance of activities they are capable of doing). Falls were reported using descriptive statistics. Ordinary least squares regression was used to evaluate the relationships between the independent variables (i.e., fall status and fear of falling) and each dependent variable (i.e., questionnaire scores).
Seventy-one individuals were enrolled in the study; however, 11 participants were lost to follow-up. The included participants ( = 60) were 58.4 ± 14.6 years old and 99 ± 60.3 days post-injury. Over one third (38.3%) of participants fell over the 6-month tracking period. Twenty-seven participants (45%) reported a fear of falling and 14 (51.9%) of these participants were fallers. Fear of falling significantly predicted scores of autonomy indoors (β = 3.38, = 0.04), autonomy outdoors (β = 2.62, = 0.04) and family role (β = 3.52, = 0.05).
Individuals with subacute SCI and a fear of falling experienced reduced participation and autonomy, but with no differences in life satisfaction compared to those without a fear of falling. In contrast, having experienced a fall did not impact participation, autonomy or life satisfaction. In the first year after SCI, rehabilitation programs should place specific attention on the presence of fear of falling to help individuals with SCI prepare for everyday mobility challenges.
脊髓损伤（SCI）患者参与有意义活动的程度降低，导致社交参与减少和产生负面心理影响。可能影响脊髓损伤后参与度的两个因素是跌倒状况（例如，曾经历过跌倒）和害怕跌倒。我们的目的是研究跌倒状况和害怕跌倒是否以及如何影响损伤后第一年的参与度、自主性和生活满意度。
招募了一家脊髓损伤康复医院的成年住院患者。出院后，对跌倒情况进行了6个月的跟踪，至少跌倒过一次的参与者被归类为“跌倒者”。在6个月期间结束时，发放了《参与和自主性影响问卷》以及《生活满意度问卷9》，并询问参与者是否害怕跌倒（即持续担心跌倒导致避免进行他们有能力做的活动）。使用描述性统计报告跌倒情况。采用普通最小二乘法回归来评估自变量（即跌倒状况和害怕跌倒）与每个因变量（即问卷得分）之间的关系。
71人参与了该研究；然而，11名参与者失访。纳入的参与者（n = 60）年龄为58.4±14.6岁，损伤后99±60.3天。超过三分之一（38.3%）的参与者在6个月的跟踪期内跌倒。27名参与者（45%）报告害怕跌倒，其中14名（51.9%）参与者是跌倒者。害怕跌倒显著预测了室内自主性得分（β = 3.38，p = 0.04）、室外自主性得分（β = 2.62，p = 0.04）和家庭角色得分（β = 3.52，p = 0.05）。
与不害怕跌倒的亚急性脊髓损伤患者相比，害怕跌倒的患者参与度和自主性降低，但生活满意度没有差异。相比之下，曾经历过跌倒并未影响参与度、自主性或生活满意度。在脊髓损伤后的第一年，康复计划应特别关注害怕跌倒的情况，以帮助脊髓损伤患者应对日常移动挑战。
