Factors Associated With Recurrent Falls in Individuals With Traumatic Spinal Cord Injury: A Multicenter Study

Abstract Objective To identify factors associated with recurrent falls in individuals with traumatic spinal cord injury (SCI). Design Cross-sectional multicenter study. Setting Two specialized rehabilitation centers. Participants Included: individuals with traumatic SCI ≥1 year postinjury who were aged ≥18 years. Excluded: individuals with motor complete injuries above C5 or below L5. The study sample comprised participants (N=224; 151 wheelchair users, 73 ambulatory; 77% men; mean age ± SD, 50±15y; median time since injury, 15y [range, 1–56y]) who were consecutively recruited at regular follow-up. Interventions Not applicable. Main Outcome Measure Primary outcome was factors associated with recurrent falls (defined as low frequent [0–2] or recurrent [>2]) the previous year. Independent variables were demographic data, wheelchair user or ambulatory, work, health-related quality of life, risk willingness, alcohol consumption, ability to get up from the ground, and exercise habits. Results Fifty percent reported recurrent falls. In the final multiple logistic regression model, ambulation (odds ratio [OR]=2.67; 95% confidence interval [CI], 1.33–5.37), ability to get up from the ground (OR=2.22; 95% CI, 1.21–4.10), and regular exercise (OR=1.86; 95% CI, 1.05–3.31) were associated with recurrent falls ( P ≤.05), and with increasing age the OR decreased (OR=.97; 95% CI, .95–.99). Conclusions Individuals with SCI should be considered at risk of recurrent falls, and thereby at risk of fall-related injuries. Fall prevention programs should be focused on ambulatory, younger, and more active individuals who had the highest risks for recurrent falls.