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Fear of Falls, Injuries Can Plague Motorized Wheelchair Users

TUESDAY, August 6, 2024 (HealthDay News) — When people who use wheelchairs or motorized scooters get hurt in a fall, fear that it will happen again may keep them on the sidelines of life, a new study warns.

Falls may cause minor bruises and scrapes or result in broken bones and other more serious injuries. While many researchers have studied falls among people who are ambulatory and have conditions like Parkinson's disease, few have looked at falls among those who rely on assistive devices most or all of the time. 

More than 5 million Americans use a motorized scooter or wheelchair to get around. Those who use them 40 hours or more a week often find obstacles in their way, which sometimes cause them to fall, new research shows. 

"While a cut or scrape may seem minor, for someone with diminished sensation, that can quickly turn into a bigger problem," said study leader Laura Rice, a professor of health and kinesiology at the University of Illinois at Urbana-Champaign.

The new study — recently published in the journal Disability and Rehabilitation — analyzed data from an online survey completed by 156 people. All used a wheelchair or scooter full-time and had fallen at least once in the past three years. Respondents included both younger and older adults (median age: 33). 

In all, 96% said they had fallen at least once in the previous year, and 74% had been injured. Notably, 95% said they were afraid of falling again.

Those who had been hurt had higher levels of anxiety and used their chairs or scooters less often than other respondents, the survey revealed.

"We can't tell what's causing what," Rice said in a news release. "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."

This, she said, can lead to something dubbed the "disuse disability cycle": As people stop doing activities, their physical capacity to do so declines, increasing the likelihood of a fall. 

"It's a vicious cycle," Rice said.

Study co-author Sahel Moein, a doctoral student in kinesiology, noted that participants who had been injured in falls tended to be younger than those who escaped injury.

"This is in contrast with many of the previous findings among community-dwelling adults, where older age was associated with falls and their consequences," she said in the news release. "So we believe that people who are younger have riskier behaviors, which put them at higher risk of experiencing injuries."

Based on their findings, researchers called on health care providers to gauge wheelchair and scooter users' fall risk and offer preventive safety training. 

They are testing an intervention to help prevent falling. Study co-author Elizabeth Petersen, a clinical professor of occupational therapy at the University of Illinois Chicago, said it would be provided by occupational or physical address. 

The program lets participants practice transfer and other wheelchair skills and helps them prepare for managing falls when they occur, Petersen said.

Researchers called on health care providers to be aware of risks facing patients who use assistive devices.

"Health care providers sometimes think that giving someone a wheelchair will solve their problem of falling," Rice said. "But people also need to be trained to use the new equipment and how to cope with the challenges that come with these devices."

More information

The National Library of Medicine has a fall-prevention guide for those who rely on wheelchairs. 

SOURCE: University of Illinois at Urbana-Champaign, news release, July 30, 2024

August 6, 2024
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