Journal of Rehabilitation Research & Development (JRRD)

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Volume 47 Number 5, 2010
   Pages 497 — 502

Abstract — Postural control and fear of falling in persons with low-level paraplegia

Ligie T. John, BPT; Binu Cherian, BPT, PGDHM;* Andrew Babu, MPT

Physiotherapy Service, Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India

Abstract — Falls are prevalent reasons for spinal cord injury (SCI). Postinjury fear of falling (FOF) can affect rehabilitation potential. We quantified FOF in 15 men with paraplegia (ambulatory with bilateral knee-ankle-foot orthoses [KAFOs] and elbow crutches) in correlation with their postural control at the center for long-term SCI rehabilitation of a tertiary-care teaching hospital. Our outcome measures comprised the American Spinal Injury Association Impairment Scale, the Modified Falls Efficacy Scale (MFES), postural sway measurements in the anteroposterior and mediolateral directions; and walking speed, cadence, and endurance. We assessed FOF with the MFES followed by measuring postural sway with a force platform. We measured gait parameters by asking the participant to ambulate on an indoor pathway. The mean postural sway was 314.13 +/- 184.05 mm (mean +/- standard deviation) in the anteroposterior direction and 222.16 +/- 112.34 mm in the mediolateral direction. The MFES score was 41.29 +/- 12.77, which showed a statistically significant negative correlation with postural control. The self-perception of confidence as measured by MFES might not really represent the actual postural stability in individuals with low-level paraplegia. FOF can adversely affect the postural control of individuals with low-level paraplegia. Clinicians should consider FOF as an influential factor in postural control during rehabilitation.

Key words: ambulation, fear of falling, knee-ankle-foot orthoses, paraplegia, postural control, rehabilitation, spinal cord injury, walking cadence, walking endurance, walking speed.

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Last Reviewed or Updated  Tuesday, July 27, 2010 3:52 PM

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