A Falls Concern Scale for people with spinal cord injury (SCI-FCS)

Study design: Observational study and cross-sectional survey. Objectives: To develop a scale assessing concern about falling in people with spinal cord injuries who are dependent on manual wheelchairs, and to evaluate psychometric properties of this new scale. Setting: Community and hospitals, Australia. Methods: The Spinal Cord Injury-Falls Concern Scale (SCI-FCS) was developed in consultation with SCI professionals. The SCI-FCS addressed concern about falling during 16 activities of daily living associated with falling and specific to people with SCI. One hundred and twenty-five people with either acute or chronic SCI who used manual wheelchairs were assessed on the SCI-FCS and asked questions related to their SCI and overall physical abilities. A subgroup of 20 people was reassessed on the SCI-FCS within 7 days. Results: The SCI-FCS had excellent internal and test–retest reliability (Cronbach's α=0.92, intra-class correlation coefficient (ICC)=0.93). Factor analysis revealed three underlying dimensions of the SCI-FCS addressing concern about falling during activities that limit hand support and require movement of the body's centre of mass. The discriminative ability of the SCI-FCS between different diagnostic groups indicated good construct validity. Subjects with a high level of SCI, few previous falls, dependence in vertical transfers and poor perceived sitting ability demonstrated high levels of concern about falling. Conclusions: This study suggests that the SCI-FCS is a valid and reliable tool for assessing concern about falling in people with SCI dependent on manual wheelchairs. The SCI-FCS could also assist in determining the effectiveness of fall minimization programs.