Understanding the Physical and Psychological Impact of Falls in Ambulatory Individuals with CP

Richard_Scope

Scope and the University of Nottingham are working on a UK Falls study:

"Falling in the lives of adults with Cerebral Palsy: Taking action to prevent, manage, and support through the life course."

It will add weight to a growing body of research but from a UK perspective.

The Research below is the latest paper from the Cerebral Palsy Research Network

The Cerebral Palsy (CP) Research Network congratulates Marissa Esterly, MS and Liz Boyer, PhD and their co-authors,[*] for the publication of the 17th CP Research Network manuscript, “Physical and Psychosocial Consequences of Falls in Ambulatory Individuals with Cerebral Palsy by Age and Gross Motor Function.” This new study published in the Archives of Physical Medicine and Rehabilitation sheds light on the frequency, risks, and consequences of falls in ambulatory individuals with cerebral palsy (CP). The study, conducted by a team of researchers and individuals with lived experience specializing in CP and rehabilitation, highlights the physical and emotional toll of falls for individuals with CP who walk, as well as strategies for prevention and improved care. The study team was able to rapidly recruit adult participants over 40 years of age GMFCS I-III through the engaged community of MyCP members and send out surveys efficiently through the CP Research Network Community Registry platform to ensure a broad range of ages were included in this project.

Falls Are Common in CP
The study surveyed 381 people with CP, ranging from children to older adults (ages 5-76). It found that 86% had experienced at least one fall in the past year. Children aged 5-12 and individuals with moderate mobility impairment (GMFCS Level II) reported the highest fall rates. Most falls occurred while walking on uneven surfaces or when feeling fatigued.

Injuries from Falls Increase with Age
More than half of those surveyed (55%) experienced at least one serious injury due to a fall. The likelihood of severe injuries, such as fractures and concussions, increased with age. Among participants aged 50 and older, 80% reported experiencing a significant fall-related injury. Head injuries, including cuts requiring stitches and concussions, and fractures were among the most common types of trauma.

The Emotional Impact of Falls
Beyond physical injuries, falls also have a significant psychological impact. Falls can be frustrating and embarrassing. Many people in the study said they lost confidence after falling. Older individuals and those with more mobility challenges (GMFCS level III) were the most worried about falling. Because of this fear, some people avoided activities they enjoyed, which can reduce their independence and mobility.

Recommendations for Fall Prevention
Given the high risk of falls and injuries, the study emphasizes the importance of proactive fall prevention strategies, including:

• Regular Fall Tracking: Keeping a record of falls can help individuals and their healthcare providers identify patterns and develop prevention plans.
• Strength and Balance Training: Balance-specific physical therapy and regular exercise can improve stability and reduce fall risk.
• Environmental Modifications: Making sure that home and public spaces are free of tripping hazards can significantly lower fall occurrences.
• Addressing Mental Health Concerns: Support groups, counselling, and education on fall prevention can help individuals regain confidence and maintain an active lifestyle.

Falls remain a major concern for ambulatory individuals with CP, impacting both physical health and quality of life. This study underscores the need for greater awareness, proactive prevention efforts, and continued research into effective fall management strategies. By working together—individuals with CP, caregivers, and medical professionals—we can reduce fall risks and improve overall mobility and independence.

The full journal article is available in the Archives of Physical Medicine and Rehabilitation for those interested in further details about the study’s findings for free until February 23, 2025. After February 23, 2025, only subscribers to The Archives of Physical Medicine and Rehabilitation will have access. Marissa Esterley, MS, Clinical Research Coordinator and lead author partnered with Dr. Liz Boyer, PhD, Co-Director of the Gillette Children’s Cerebral Palsy Institute Research Program in St. Paul, Minnesota and Adjunct Assistant Professor at the University of Minnesota in the Orthopedic Surgery Department to create the study, collect the data, and analyze the data alongside lived experience partners.

[*] Linda E. Krach, MD, Kari Pederson, MSW, LICSW, Nathan G. Wandersee, ABA, Sandy Callen Tierney, MSSW, PhD