Therapists’ perspectives on fall prevention in spinal cord injury rehabilitation: a qualitative study

Abstract

Purpose

Therapists play a key role in delivering fall prevention/management education to individuals with spinal cord injury/disease, yet their perspectives on this topic remain understudied. Here, we described the perspectives of physical and occupational therapists who routinely provided rehabilitation to patients with spinal cord injury/disease on: (1) how fall risk was assessed, (2) what fall prevention education, interventions or strategies were provided, and (3) opportunities to improve fall risk assessment and the delivery of fall prevention education, strategies and interventions.

Materials and methods

Twenty-one therapists completed an individual interview or focus group that was analyzed using an inductive thematic analysis.

Results

Four main themes were identified: (1) policy and procedures impact practice (i.e., policy and procedures positively and negatively impact practice), (2) assessing and managing fall risk/falls in patients with spinal cord injury/disease (i.e., discipline-specific roles in fall risk assessments and fall management processes in rehabilitation), (3) fall prevention and management education (i.e., helicopter therapists and challenges with fall prevention and management education), (4) building insight into fall risk and management (e.g., building insight into fall risk for patients and therapists).

Conclusions

This study revealed opportunities to improve the delivery of fall prevention education and training to individuals with spinal cord injury/disease.

IMPLICATIONS FOR REHABILITATION

• Fall prevention education should be initiated in spinal cord injury rehabilitation and then reinforced in community rehabilitation.

• Barriers and challenges faced by therapists when delivering fall prevention and management education/training in spinal cord injury rehabilitation include their perceptions of a patient’s readiness to receive fall prevention education, short length of stay in rehabilitation, organization’s expectations of zero falls and a lack of spinal cord injury-specific fall prevention resources.

• Therapists who work in spinal cord injury rehabilitation may benefit from information about fall risk factors encountered by individuals with spinal cord injury/disease in the community.

Keywords:

• Accidental falls
• spinal cord injuries
• allied health personnel
• rehabilitation
• qualitative research

Acknowledgements

We would like to thank the participants for their time and assistance with this study.

Disclosure statement

The authors report no conflicts of interest. SBJ holds the Toronto Rehabilitation Institute Chair-University Health Network at the University of Toronto.

Additional information

Funding

This work was supported by the Craig H. Neilsen Foundation under the Psychosocial Research Grant to KEM and a Canadian Institutes of Health Research Fellowship and Toronto Rehabilitation Institute Student Scholarship to HS.