A survey for characterizing details of fall events experienced by lower limb prosthesis users

Abstract

Despite their importance to fall prevention research, little is known about the details of real-world fall events experienced by lower limb prosthesis users. This gap can be attributed to the lack of a structured, population-specific fall survey to document these adverse health events. The objective of this project was to develop a survey capable of characterizing the circumstances and consequences of fall events in lower limb prosthesis users. Best practices in survey development, including focus groups and cognitive interviews with diverse samples of lower limb prosthesis users, were used to solicit input and feedback from target respondents, so survey content would be meaningful, clear, and applicable to lower limb prosthesis users. Focus group data were used to develop fall event definitions and construct a conceptual fall framework that guided the creation of potential survey questions and response options. Survey questions focused on the activity, surroundings, situation, mechanics, and consequences of fall events. Cognitive interviews revealed that with minor revisions, survey definitions, questions, and response options were clear, comprehensive, and applicable to the experiences of lower limb prosthesis users. Administration of the fall survey to a national sample of 235 lower limb prosthesis users in a cross-sectional preliminary validation study, found survey questions to function as intended. Revisions to the survey were made at each stage of development based on analysis of participant feedback and data. The structured, 37-question lower limb prosthesis user fall event survey developed in this study offers clinicians and researchers the means to document, monitor, and compare fall details that are meaningful and relevant to lower limb prosthesis users in a standardized and consistent manner. Data that can be collected with the developed survey are essential to establishing specific goals for fall prevention initiatives in lower limb prosthesis users.

The number of falls recalled in the past year and balance confidence predict the frequency of injurious falls by unilateral lower limb prosthesis users

“…The development of a definition for injurious falls that is both clear and meaningful to key stakeholders, including LLP users (i.e., what do LLP users consider to be an injurious fall), researchers, and health insurance providers, would ensure that future research reflects what matters most about injurious falls to LLP users, and help standardize data collection across studies so that a comparison and aggregation of data between studies is possible. 41 Methods used to ascertain the frequency of injurious falls may also have contributed to the differences between studies. Three of the four studies that have characterized injurious falls in LLP users did so using a cross-sectional study design and retrospective recall of fall events.…”

“…Broadening what was considered an injurious fall likely contributed to the higher reported incidence and rate of injurious falls by LLP users in the current study. The development of a definition for injurious falls that is both clear and meaningful to key stakeholders, including LLP users (i.e., what do LLP users consider to be an injurious fall), researchers, and health insurance providers, would ensure that future research reflects what matters most about injurious falls to LLP users, and help standardize data collection across studies so that a comparison and aggregation of data between studies is possible 41 …”

“…’ If participants reported one or more falls, they were asked to describe the circumstances and injuries associated with each fall. Fall circumstances were collected using a preliminary version of the Lower Limb Prosthesis Users Fall Event Survey, which classifies fall circumstances into four categories: activity, surroundings, situation, and mechanics 41 . To ascertain whether a fall was injurious, participants were asked ‘ did you experience an injury because of this fall?…”

“…Fall circumstances were collected using a preliminary version of the Lower Limb Prosthesis Users Fall Event Survey, which classifies fall circumstances into four categories: activity, surroundings, situation, and mechanics. 41 To ascertain whether a fall was injurious, participants were asked 'did you experience an injury because of this fall?' If participants reported an injury, they were asked to describe the nature of the injury including the type (e.g., fracture, sprain, pain) and location of the injury (e.g., arm, leg), and whether they sought and/or received medical attention.…”