Physical and psychosocial consequences of falls in individuals with cerebral palsy

Abstract

ABSTRACTAimTo quantify fall frequency, characteristics, injuries, and psychosocial impact across the lifespan and between Gross Motor Classification System (GMFCS) levels in cerebral palsy (CP).MethodAmbulatory individuals with CP (201 adults) or minors’ caregivers (180) completed online surveys on falls and their physical and psychosocial consequences for this cross-sectional study.ResultsAlmost everyone fell in the past year (86%); GMFCS level II fell most often. Having experienced serious fall-related injuries (e.g., head/face stitches, concussion) increased with age, affecting 80% of ≥50-year-olds. Forward falls caused by tripping during shod ambulation were common. Uneven surfaces and fatigue were notable causes. Concern about falling and associated activity avoidance was highest for GMFCS level III. Psychosocial consequences of falls (e.g., embarrassment, lost confidence) were elevated across GMFCS levels. Nearly everyone (88%) wished they fell less.InterpretationFall frequency in ambulatory children and adults with CP is 2-3-fold higher than the general older adult population. Physical and psychosocial consequences of falls were frequent and impacted life choices. Differences observed by GMFCS level and age should be considered in care delivery. Clinically tracking and discussing falls and their repercussions across the lifespan will aid in addressing this under-researched and under-resourced concern of people with CP.WHAT THIS PAPER ADDSAmong 381 individuals with CP, 86% fell in the past year.Falling was most common among 5-12-year-olds and GMFCS level II.Head/face stitches, fractures, sprained knee/ankle, and concussions were common serious injuries.Participants experienced high levels of embarrassment, pain, and loss of confidence.GMFCS level III had the greatest fall concern and avoidance behavior.