Characteristics and consequences of falls in people who use wheelchairs in long-term care settings.

Research Objectives: To understand the characteristics and consequences of falls in individuals using wheelchairs in long-term care settings.

Design: We performed a secondary descriptive data analysis on video recordings of falls in two long-term care facilities accessed via Databrary.

Setting: Long-term care setting

Participants: Participants were older adult wheelchair users. A total of 58 wheelchair fall videos (from 32 participants) were identified out of 300 total videos (from 118 individuals).

Interventions: Not applicable.

Main Outcome Measures: The validated Falls Video Analysis Questionnaire was adapted from the original version to assess the causal, behavioral, and environmental aspects of falls from wheelchairs.

Results: Wheelchair falls (n=58) were most often caused by incorrect transfer or shift of body weight (70.7%, n=41). 89.7% (n=46) struck their pelvis during the fall. Improper brake position contributed to a fall 67.2% (n=39) of the time. Participants most often fell backward (56.9%, n=33). Head impacts occurred more frequently in the forward landing configuration (66.7%, n=2) than in the backward (8.3%, n=3) and sideways (23.5%, n=4) landing configurations. Only 25% (n=3) of the forward direction falls landed with a forward landing configuration, suggesting a protective rotational response midfall in the majority of forward direction falls. Other protective responses to all falls included step (10.3%, n=6) and reach-to-grasp (8.6%, n=5) responses.

Conclusions: The findings highlight the unique nature of falls in older adults who utilize wheelchairs in long-term care settings. Overall, the results of this study support the development of specialized fall prevention strategies for wheelchair users.

Author(s) Disclosures: None to disclose