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Perceptions of Fall Circumstances, Recovery Methods and Community Participation in Manual Wheelchair Users.

OBJECTIVE: To examine the circumstances surrounding the worst fall experienced by full time manual wheelchair users in the past 12 months, the recovery process, and influence on community participation.

DESIGN: Mixed-methods. Semi-structured interviews were conducted to understand the circumstances of the worst fall experienced and the recovery process. A quantitative fear of falling assessment and the Community Participation Indicators (CPI) were used to further evaluate the influence of the fall.

RESULTS: 20 manual wheelchair users, 47 ± 13 years old (mean ± SD), 55% male. Falls most commonly occurred outside during wheelchair propulsion. Falls were attributed to both intrinsic and extrinsic factors. 70% of participants reported a fear of falling and 80% required assistance to recovery. No significant correlations were found between fall frequency and CPI scores. Participants who needed assistance to recover (56.70 ± 17.66) had lower CPI importance scores compared to participants able to recover independently (88.93 ± 22.13), P= 0.05.

CONCLUSION: Falls are complex and the majority of manual wheelchair users need assistance to recover. Comprehensive programs including education on prevention and post fall management are needed. Results may increase understanding of the circumstances associated with falls and inform the development of evidenced-based clinical practice guidelines.

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