Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: A mixed methods approach using photovoice.

Introduction: Wheelchair users with spinal cord injury are at a high risk of falls. However, the perspectives of wheelchair users with spinal cord injury on their fall circumstances and their preferences for fall prevention strategies/interventions remain understudied. Therefore, we aimed to: a) describe the circumstances of falls experienced by wheelchair users with spinal cord injury over a six-month period, b) explore their perspectives of why falls occurred in certain situations, and c) explore their perspectives on recommended content/structure of fall prevention strategies/interventions.

Development of the spinal cord injury pressure sore onset risk screening (SCI-PreSORS) instrument: a pressure injury risk decision tree for spinal cord injury rehabilitation.

Study Design: Psychometric study based on retrospectively collected data.

Objective: Development of a pressure injury (PI) risk screening instrument for use during spinal cord injury (SCI) rehabilitation.

Setting: Tertiary rehabilitation center.

Factors that influence the risk of falling after spinal cord injury: a qualitative photo-elicitation study with individuals that use a wheelchair as their primary means of mobility.

Introduction: Falls are a concern for wheelchair users with spinal cord injury (SCI). Falls can negatively impact the physical and psychological well-being of fallers. To date, the perspectives of wheelchair users with lived experiences of SCI on the contributors to falls has been understudied.

Capturing the psychosocial impacts of falls from the perspectives of wheelchair users with spinal cord injury through photo-elicitation.

Purpose: While the physical consequences of falls among wheelchair users with spinal cord injury have previously been examined, the psychosocial impacts remain understudied. Here, we explored the psychosocial impacts of falls and risk of falling from the perspectives of wheelchair users with spinal cord injury.

Materials And Methods: Twelve wheelchair users (aged 41.

Development of an implementation-focused network to improve healthcare delivery as informed by the experiences of the SCI knowledge mobilization network.

Implementing research findings into clinical practice is challenging. This manuscript outlines the experiences and key learnings from a network that operated as a community of practice across seven Canadian Spinal Cord Injury (SCI) rehabilitation centers. These learnings are being used to inform a new implementation-focused network involving SCI rehabilitation programs based in Ontario, Canada.

Determining Pressure Injury Risk on Admission to Inpatient Spinal Cord Injury Rehabilitation: A Comparison of the FIM, Spinal Cord Injury Pressure Ulcer Scale, and Braden Scale.

Objective: Assess the utility of the admission Spinal Cord Injury Pressure Ulcer Scale (SCIPUS), Braden Scale, and the FIM for identifying individuals at risk for developing pressure injury during inpatient spinal cord injury (SCI) rehabilitation.

Design: Retrospective cohort.

Setting: Two tertiary rehabilitation centers.

The Spinal Cord Injury Pressure Ulcer Scale (SCIPUS): an assessment of validity using Rasch analysis.

Study Design: Secondary analysis of retrospective data.

Objective: The aim of this study was to further validate the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) using Rasch analysis.

Setting: Two rehabilitation centers in Canada.

Intensive Balance Training for Adults With Incomplete Spinal Cord Injuries: Protocol for an Assessor-Blinded Randomized Clinical Trial.

Background: Impaired reactive balance control can lead to increased falls in people with neurological impairments. Perturbation-based balance training (PBT), which involves repetitive exposure to destabilizing external perturbations, improves the ability to take reactive steps in older adults and individuals who have had a stroke.

Objective: The objective is to investigate whether PBT or conventional intensive balance training (CIBT) results in greater improvements in reactive stepping ability in individuals with chronic incomplete spinal cord injury (iSCI).

Implementation of Pressure Injury Prevention Best Practices Across 6 Canadian Rehabilitation Sites: Results From the Spinal Cord Injury Knowledge Mobilization Network.

Objective: To use the theoretical frameworks of implementation science to implement pressure injury (PI) prevention best practices in spinal cord injury (SCI) rehabilitation.

Design: Quality improvement.

Setting: Six Canadian SCI rehabilitation centers.

Psychometric Properties of the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) for Pressure Ulcer Risk Assessment During Inpatient Rehabilitation.

Objective: To assess the psychometric properties of the Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) for pressure ulcer (PU) risk assessment during inpatient rehabilitation.

Design: Prospective cohort.

Setting: Tertiary rehabilitation centers.

The application of implementation science for pressure ulcer prevention best practices in an inpatient spinal cord injury rehabilitation program.

Objectives: To implement pressure ulcer (PU) prevention best practices in spinal cord injury (SCI) rehabilitation using implementation science frameworks.

Design: Quality improvement.

Setting: SCI Rehabilitation Center.

Does the "eyes lead the hand" principle apply to reach-to-grasp movements evoked by unexpected balance perturbations?

A fundamental principle that has emerged from studies of natural gaze behavior is that goal-directed arm movements are typically guided by a saccade to the target. In this study, we evaluated a hypothesis that this principle does not apply to rapid reach-to-grasp movements evoked by sudden unexpected balance perturbations. These perturbations involved forward translation of a large (2 × 6 m) motion platform configured to simulate a "real-life" environment.

Determining the visual angle of objects in the visual field: an extended application of eye trackers.

Many eye-tracker systems display the point of central gaze fixation on video images of the viewed environment. We describe here a method for determining the visual angles of objects located in the periphery. Such data are needed to study the potential contributions of peripheral vision during cognitive and motor tasks.

The moveable handhold: a new paradigm to study visual contributions to the control of balance-recovery reactions.

Balance-recovery reactions that involve rapid step or reach-to-grasp movements are prevalent and functionally important responses to instability. Successful use of these reactions to recover balance in daily life requires a capacity to modulate the reaction to deal with the continual variation in environmental constraints that occurs as the person moves, i.e.

Stepping to recover balance in complex environments: is online visual control of the foot motion necessary or sufficient?

Rapid step reactions evoked by balance perturbation must accommodate constraints on limb motion imposed by obstacles and other environmental features. Recent results suggest that the required visuospatial information (VSI) is acquired and stored "proactively", prior to perturbation onset (PO); however, the extent to which "online" (post-PO) visual feedback can contribute is not known. To study this, we used large unpredictable platform perturbations to evoke rapid step reactions, while subjects wore liquid crystal goggles that occluded vision: (1) prior to PO (forcing use of online-VSI), (2) after PO (forcing use of stored-VSI), or (3) not at all (normal-VSI).

Interventions to promote more effective balance-recovery reactions in industrial settings: new perspectives on footwear and handrails.

"Change-in-support" balance-recovery reactions that involve rapid stepping or reaching movements play a critical role in preventing falls. Recent geriatrics studies have led to new interventions to improve ability to execute these reactions effectively. Some of these interventions have the potential to reduce fall risk for younger persons working in industrial settings.

Preventing falls in older adults: new interventions to promote more effective change-in-support balance reactions.

"Change-in-support" (CIS) balance-recovery reactions that involve rapid stepping or reaching movements play a critical role in preventing falls; however, age-related deficits in the neuro-musculoskeletal systems may impede ability to execute these reactions effectively. This review describes four new interventions aimed at reducing fall risk in older adults by promoting more effective CIS reactions: (1) balance training, (2) balance-enhancing footwear, (3) safer mobility aids, and (4) handrail cueing systems. The training program uses unpredictable support-surface perturbations to counter specific CIS control problems associated with aging and fall risk.

Gaze behavior governing balance recovery in an unfamiliar and complex environment.

Visuospatial information regarding obstacles and other environmental constraints on limb movement is essential for the successful planning and execution of stepping movements. Visuospatial control strategies used during gait and volitional stepping have been studied extensively; however, the visuospatial strategies that are used when stepping rapidly to recover balance in response to sudden postural perturbation are not well established. To study this, rapid forward stepping reactions were evoked by unpredictable support-surface acceleration while subjects stood amid multiple obstacles that moved intermittently and unpredictably prior to perturbation onset (PO).

Sensitivity of a Hill-based muscle model to perturbations in model parameters.

Musculoskeletal simulations of human movement commonly use Hill muscle models to predict muscle forces, but their sensitivity to model parameter values is not well understood. The purpose of this study was to evaluate muscle model sensitivity to perturbations in 14 Hill muscle model parameters in forward dynamic simulations of running and walking by varying each by +/-50%. Three evaluations of the muscle model were performed based on: (1) calculating the sensitivity of the muscle model only, (2) determining the continuous partial derivatives of the muscle equations with respect to each parameter, and (3) evaluating the effects on the running and walking simulations.