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

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.