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Predictive Factors for Inpatient Falls among Children with Cerebral Palsy
Ebru Alemdaroğlu1, Sibel Demir Özbudak1, Sibel Mandiroğlu1
1Department of Physical Medicine and Rehabilitation, Ankara Physical Medicine and Rehabilitation Education and Research Hospital, Ankara (Alemdaroğlu, Özbudak Demir, Mandıroğlu, Alakoç, Girgin, Uçan), Turkey.
Insights
Behavioral issues and a history of frequent falls are key predictors of inpatient falls in children with cerebral palsy (CP). Identifying these risk factors can help prevent falls in hospitalized children with CP.
Area of Science:
- Pediatrics
- Neurology
- Rehabilitation Medicine
Background:
- Inpatient falls are a significant concern in pediatric rehabilitation settings.
- Children with cerebral palsy (CP) are particularly vulnerable to falls due to their underlying condition.
Purpose of the Study:
- To identify predictors of inpatient falls in children with cerebral palsy (CP).
- To inform early identification and prevention strategies for falls in hospitalized children with CP.
Main Methods:
- A prospective study involving 93 children with CP.
- Assessment included medical history, physical examination, Selective Motor Control Test, Gross Motor Functional Classification System (GMFCS), Berg Balance Scale, and Manual Ability Classification System (MACS).
- Data on previous falls and falls during hospitalization were recorded.
Main Results:
- 27% of children with CP experienced inpatient falls.
- Predictors of falls included behavioral problems (OR 26.454), inability to maintain a long sitting position (OR 10.807), ability to balance on knees without support (OR 9.810), history of frequent falls (OR 4.893), and a negative Thomas test (OR 4.192).
- Fallers were younger on average than non-fallers.
Conclusions:
- Behavioral problems, frequent fall history, impaired sitting balance, a negative Thomas test, and ability to balance on knees without support are associated with increased inpatient fall risk in children with CP.
- These findings can aid in identifying high-risk individuals upon hospital admission.
- Further research is needed to develop targeted fall prevention programs for this population.
Objective:
Inpatient falls are of significant concern. The aim of this prospective study was to determine the predictors of inpatient falls among children with cerebral palsy in a rehabilitation hospital.
Design And Methods:
A total of 93 patients with cerebral palsy were assessed based on history, physical findings, the Selective Motor Control Test, the Gross Motor Functional Classification System, the Berg Balance Scale and the Manual Ability Classification System. Previous history of falls/frequent falls, and any falls which occurred during hospitalization, were recorded.
Results:
Of all 93 patients, 25 (27%) fell and 68 (73%) did not fall. The mean age of the fallers (6.3±2.0 years) was lower than that of the non-fallers (8.1±3.9 years). Behavioral problems according to the mother's statement (OR 26.454), not being able to maintain a long sitting position (OR 10.807), ability to balance on knees without support (OR 9.810), a history of frequent falls (OR 4.893) and a negative Thomas test (OR 4.192 fold) were found to increase the risk of inpatient falls.
Conclusions:
In these children with cerebral palsy, behavioral problems according to the mother's statement, a history of frequent falls, not being able to maintain a long sitting position, a negative Thomas test, and able to balance on knees without support were associated with the risk of inpatient falls. Children with cerebral palsy may experience inpatient falls. Further studies are required in order to develop prevention programs.
Practice Implications:
For patients diagnosed with cerebral palsy, these results may help identify possible inpatient fallers on hospital admission.
