Falls in people with mobility limitations: a cross-sectional analysis of a US registry of assistive device users

Abstract

Purpose of the Article: To (1) summarise the personal and clinical characteristics of persons with disabilities (PwDs) in the US who were evaluated for mobility assistive equipment (MAE) in the functional mobility assessment and uniform dataset (FMA/UDS) and (2) stratify subpopulations of PwD who reported falling versus those who do not report a fall.

Materials and Methods: This study was a retrospective, descriptive cohort analysis of adults with disabilities using the FMA/UDS. Data are collected during a user’s initial evaluation for a new mobility device. The sample is intentionally general to be inclusive of all mobility device users. The primary variable of interest was a patient-reported fall within the 3 months leading up to their evaluation for a new mobility device. Subpopulation characteristics were stratified by this binary fall variable.

Results and Conclusions: This study provides descriptions of PwDs being evaluated for a new mobility device. There were 11,084 PwDs with 31 different primary diagnoses. During their new mobility device evaluation, 52.2% of PwDs reported at least one fall in the last 3 months. For those who reported a fall, 46.6% of PwDs were using a walking aid or no device at all before the new mobility device evaluation. Additionally, persons with progressively acquired disabilities (i.e., Parkinson’s disease, osteoarthritis and cardiopulmonary disease) reported higher rates of falls than those with congenital disabilities (i.e., cerebral palsy and spina bifida). These findings will influence future studies comparing different types of devices and their influence on falls and user satisfaction.

Implications for rehabilitation

• 52.2% of persons with disabilities (PwDs) seeking a new wheelchair evaluation reported at least one fall in the last 3 months.

• Persons with progressively acquired disabilities (i.e., Parkinson’s disease, osteoarthritis and cardiopulmonary disease) reported higher rates of falls than those with congenital disabilities (i.e., cerebral palsy and spina bifida).

• Earlier interventions for fall prevention including professional wheelchair evaluations may be warranted, but further research is necessary to explore long-term effectiveness.

Keywords:

• Wheelchairs
• health services for people with disabilities
• retrospective studies
• patient reported outcome measure
• falls

Disclosure statement

Dr. Schmeler reports grants from Van G. Miller Group/U.S. Rehab during the conduct of the study and personal fees from Functional Mobility Assessment Royalties outside the submitted work.

Additional information

Funding

The contents of this publication were developed under a Corporate Research Agreement (Award ID: SRA00000765) between the University of Pittsburgh and the Van G. Miller (VGM) & Associates. Additionally, this project was funded as a sub-award through the Learning Health Systems Rehabilitation Research Network (LeaRRn). LeaRRn is supported by the National Institutes of Health under Award Number 1P2CHD101895-01 through the Eunice Kennedy Shriver National Institute of Child Health and Human Development and the National Institute of Nursing Research and by the National Center for Advancing Translational Sciences of the NIH, Grant/Award Number: TL1TR001858.

Notes on contributors

Corey Morrow

Corey Morrow is an Assistant Professor at the Medical University of South Carolina. His primary research goal is to improve patients’ access to rehabilitation care and technology.

Richard Schein

Richard Schein is a Research Health Scientist within the Department of Rehabilitation Science & Technology at the University of Pittsburgh. Schein serves as an investigator and manager in the conduct of research projects, coordinating projects & budgets, and day-to-day operations.

Gede Pramana

Gede Pramana is a data scientist and works on several projects within the Department of Rehabilitation Science & Technology at the University of Pittsburgh.

Christine McDonough

Christine McDonough is an assistant professor in the Department of Physical Therapy and in Orthopaedic Surgery. Her primary areas of research include the development and testing of patient-centered outcome measures using item response theory, and clinical and health services research in fall and fracture prevention.

Mark Schmeler

Mark Schmeler is the vice chair for education & training in the Department of Rehabilitation Science & Technology at the University of Pittsburgh. Schmeler has 30 years of clinical experience and continues to practice as an Occupational Therapist and Assistive Technology Professional in the Center for Assistive Technology at the University of Pittsburgh Medical Center.