Fear of Falling, Community Participation, and Quality of Life Among Community-Dwelling People Who Use Wheelchairs Full Time

JongHun Sung; Sa Shen; Elizabeth W Peterson; Jacob J Sosnoff; Deborah Backus; Laura A Rice

doi:10.1016/j.apmr.2020.11.013

Fear of Falling, Community Participation, and Quality of Life Among Community-Dwelling People Who Use Wheelchairs Full Time

Arch Phys Med Rehabil. 2021 Jun;102(6):1140-1146. doi: 10.1016/j.apmr.2020.11.013. Epub 2020 Dec 22.

Authors

JongHun Sung¹, Sa Shen², Elizabeth W Peterson³, Jacob J Sosnoff⁴, Deborah Backus⁵, Laura A Rice⁶

Affiliations

¹ Department of Human Performance and Sport Studies, College of Education, Idaho State University, Pocatello, ID. Electronic address: sungjong@isu.edu.
² Center for Health, Aging, and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL.
³ Department of Occupational Therapy, University of Illinois at Chicago, Chicago, IL.
⁴ Center for Health, Aging, and Disability, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL; Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL; Illinois Multiple Sclerosis Research Collaborative, Urbana, IL.
⁵ Crawford Research Institute, Shepherd Center, Atlanta, GA.
⁶ Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Urbana, IL; Illinois Multiple Sclerosis Research Collaborative, Urbana, IL.

PMID: 33347892
DOI: 10.1016/j.apmr.2020.11.013

Abstract

Objectives: To examine the differences in community participation and quality of life (QOL) among individuals who use wheelchairs full time with and without fear of falling (FOF).

Design: Cross-sectional study design.

Setting: University research laboratory.

Participants: Individuals (N=85) who use a manual or power wheelchair full time who are living with various health conditions and have a history of at least 1 fall in the past 12 months (age, 45.4±15.8y; disability duration, 21.5±13.6y) were included. Forty-six (54%) were manual wheelchair users.

Interventions: Not applicable.

Main outcome measures: To quantify FOF, participants responded (yes/no) to the question: "Are you worried or concerned that you might fall?" Community participation and QOL were indexed by the Community Participation Indicator (CPI) and the World Health Organization Quality of Life-Brief version (WHOQOL-BREF), respectively. A multivariate analysis of variance (MANOVA) was performed to examine the differences in CPI and WHOQOL-BREF scores among wheelchair users who reported FOF and no FOF.

Results: A total of 54 participants (63.5%) reported that they were worried or concerned about falling. The MANOVA revealed significant differences in overall CPI (F_2,82=4.714; P=.012; Wilks' λ=0.897) and WHOQOL-BREF (F_4,63=3.32; P=.016; Wilks' λ=.826) scores. Participants who reported FOF demonstrated significantly lower CPI and WHOQOL-BREF scores compared with those who did not report FOF.

Conclusions: FOF and associated activity curtailment are prevalent and may be a factor influencing full time wheelchair users' community participation and QOL. Prospective research is needed to better understand how FOF influences community participation and QOL among individuals who use wheelchairs full time. Findings would support the development of interventions, specifically for individuals who use wheelchairs full time, to reduce FOF and improve community participation and QOL.

Keywords: Community participation; Quality of life; Rehabilitation; Wheelchairs.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Accidental Falls
Community Participation / psychology
Cross-Sectional Studies
Disabled Persons / psychology*
Fear / psychology
Female
Humans
Independent Living / psychology*
Male
Middle Aged
Quality of Life / psychology*
Wheelchairs / psychology*