Failures in dual-task obstacle crossing could predict risk of future fall in independent ambulatory individuals with spinal cord injury

Abstract

Objective: To determine whether cognitive-motor interference using ability of dual-task obstacle crossing could predict a risk of fall in 90 ambulatory individuals with spinal cord injury. Design: Six-month prospective study. Setting: A rehabilitation center and community hospitals. Subjects: Independent ambulatory individuals with spinal cord injury. Main outcome measures: Subjects were interviewed and evaluated for personal characteristics, dual-task obstacle crossing ability, and functional ability using the 10 Meter Walk Test, Timed Up and Go Test, and Five Times Sit-to-Stand Test. Then they were prospectively monitored for fall data every month for six months in total. Results: A total of 90 chronic ambulatory individuals with spinal cord injury with an average age of 52.51 ± 13.43 years, who mostly had mild lesion severity (n = 71, 79%) and walked with a walking device (n = 54, 60%) completed in the study. More than one-third of the subjects (n = 32, 36%) failed in dual-task obstacle crossing. The failures were obviously associated with the fall (unadjusted odds ratio = 7.07, P < 0.002, power = 1.000). Conclusion: Cognitive-motor interference is important for ambulatory individuals with spinal cord injury, as it could detect those with low functional ability and risk of future falls.