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Published on: June 16, 2016
A Falls Concern Scale for people with spinal cord injury (SCI-FCS)
C L Boswell-Ruys1, L A Harvey, K Delbaere
1Prince of Wales Medical Research Institute, University of New South Wales, Randwick, New South Wales, Australia. c.boswell-ruys@powmri.edu.au
Study Design:
Observational study and cross-sectional survey.
Objectives:
To develop a scale assessing concern about falling in people with spinal cord injuries who are dependent on manual wheelchairs, and to evaluate psychometric properties of this new scale.
Setting:
Community and hospitals, Australia.
Methods:
The Spinal Cord Injury-Falls Concern Scale (SCI-FCS) was developed in consultation with SCI professionals. The SCI-FCS addressed concern about falling during 16 activities of daily living associated with falling and specific to people with SCI. One hundred and twenty-five people with either acute or chronic SCI who used manual wheelchairs were assessed on the SCI-FCS and asked questions related to their SCI and overall physical abilities. A subgroup of 20 people was reassessed on the SCI-FCS within 7 days.
Results:
The SCI-FCS had excellent internal and test-retest reliability (Cronbach's alpha=0.92, intra-class correlation coefficient (ICC)=0.93). Factor analysis revealed three underlying dimensions of the SCI-FCS addressing concern about falling during activities that limit hand support and require movement of the body's centre of mass. The discriminative ability of the SCI-FCS between different diagnostic groups indicated good construct validity. Subjects with a high level of SCI, few previous falls, dependence in vertical transfers and poor perceived sitting ability demonstrated high levels of concern about falling.
Conclusions:
This study suggests that the SCI-FCS is a valid and reliable tool for assessing concern about falling in people with SCI dependent on manual wheelchairs. The SCI-FCS could also assist in determining the effectiveness of fall minimization programs.
