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Perceptions of Fall Circumstances, Recovery Methods, and Community Participation in Manual Wheelchair Users

Rice, Laura A. PhD; Peters, Joseph MS; Sung, JongHun MS; Bartlo, Wendy D. PhD; Sosnoff, Jacob J. PhD

American Journal of Physical Medicine & Rehabilitation: August 2019 - Volume 98 - Issue 8 - p 649–656
doi: 10.1097/PHM.0000000000001161
Original Research Articles
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Objective The aim of the study was to examine the circumstances surrounding the worst fall experienced by full-time manual wheelchair users in the past 12 mos, the recovery process, and influence on community participation.

Design A mixed-method research study was conducted. Semistructured interviews were conducted to understand the circumstances of the worst fall experienced and the recovery process. A quantitative fear of falling assessment and the community participation indicators were used to further evaluate the influence of the fall.

Results There were 20 manual wheelchair users (mean ± SD, 47 ± 13 yrs, 55% male). Falls most commonly occurred outside during wheelchair propulsion. Falls were attributed to both intrinsic and extrinsic factors. Seventy percent of participants reported a fear of falling and 80% required assistance to recovery. No significant correlations were found between fall frequency and community participation indicator scores. Participants who needed assistance to recover (56.70 ± 17.66) had lower community participation indicator importance scores compared with participants able to recover independently (88.93 ± 22.13), P = 0.05.

Conclusions Falls are complex and most manual wheelchair users need assistance to recover. Comprehensive programs including education on prevention and postfall management are needed. Results may increase understanding of the circumstances associated with falls and inform the development of evidenced-based clinical practice guidelines.

From the Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois (LAR, JP, JHS, JJS); and Center on Health, Aging, and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois (WDB, JJS).

All correspondence should be addressed to: Laura A. Rice, PhD, 219 Freer Hall, 906 S Goodwin Ave, Urbana, IL 61801.

This study was supported by Permobil, AB.

These data have not been presented at any professional conference.

Joseph Peters and JongHun Sung are in training.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.ajpmr.com).

Online date: , 2019

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