A new study published in Disability and Rehabilitation examined wheelchair riders who experience falls and fall-related injuries — and how those incidents impacted their lives going forward.
The research — “Factors associated with fear of falling and fall-related injuries among people who use wheelchairs and motorized mobility scooters: a cross-sectional study” — was published in the June 23 edition of the journal. The study’s authors were Sahel Moein, University of Illinois graduate student; Elizabeth W. Peterson, clinical professor, occupational therapy, University of Illinois Chicago; and Laura A. Rice, professor of health and kinesiology, University of Illinois Urbana-Champaign.
“Our research has shown that falls among wheelchair and scooter users are typically caused by interacting risk factors,” Peterson said in a July 30 news announcement from the University of Illinois Urbana-Champaign. “These may be physical, behavioral, environmental or psychological in nature.”
Rice said risk factors for falling include driving or rolling over rough terrain; transferring between wheelchairs and other surfaces; and reaching “beyond one’s base of support.”
Rice added that while falls can cause fractures and other serious injuries, even smaller injuries can be significant for wheelchair users.
“While a cut or scrape may seem minor, for someone with diminished sensation, that can quickly turn into a bigger problem,” she noted.
The research team studied data from 156 full-time wheelchair or scooter riders who had reported one or more falls in the last three years. Those participants completed online surveys that asked about their histories, frequency of mobility device use, whether they’d received training on how to prevent falls, how often they’d fallen in the last year, how afraid they were of falling, and their levels of anxiety and depression.
Researchers found that 96% of the participants — whose median age was 33 — reported falling at least once in the last year, with 74% sustaining injuries as a result. After falling, 94.6% said they were worried about falling again.
“Those who experienced fall-related injuries reported higher levels of anxiety and less frequent use of their wheelchairs or mobility scooters than their peers,” the announcement said.
“But based on clinical experience and other research — especially among ambulatory people — I think it’s likely that a fear of further injuries is causing some people to limit their activities,” Rice said in the announcement. “This can lead to something called a ‘disuse disability cycle,’ where you get into this loop of stopping doing things and then your physical capacity declines, and that puts you at more risk of falling. It’s a vicious cycle.”
Moein added that while seniors are more typically considered at higher risk for falls, “We also found that participants who experienced fall-related injuries were, on average, younger than those who did not experience such injuries. This is in contrast with many of the previous findings among community-dwelling adults, where older age was associated with falls and their consequences. So we believe that people who are younger have riskier behaviors, which put them at higher risk of experiencing injuries.”
The researchers suggested gauging wheelchair and scooter users’ fall risk and providing safety training. “The team is testing an intervention they designed to address the specific fall-prevention needs of wheelchair and scooter users,” the announcement said. “The intervention, which is delivered by occupational or physical therapists, addresses a variety of modifiable influences on fall risk.”
The intervention “uses self-management strategies like problem solving, resource utilization and action planning to build participants’ ability to prevent falls during daily activities,” Peterson said. “Participants also engage in exercise, practice transfer and other wheelchair skills, and create plans to manage falls when they happen.”