A Falls Concern Scale for people with spinal cord injury (SCI-FCS).

Abstract

Observational study and cross-sectional survey. 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. Community and hospitals, Australia. 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. 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. 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.