Influence of Transfer Quality and Wheelchair Type on Fear of Falling Among Full-Time Wheelchair Users

Objective: To evaluate the influence of transfer quality and demographics on fear of falling (FOF) among full-time wheelchair users. Design: Secondary data analysis. Setting: University research laboratory and community, United States. Participants: Ninety-six individuals (N=96) living with multiple sclerosis or spinal cord injury who use a manual or power scooter full time with median age of 54.00 years (interquartile range, 29.00 years), and median duration of health condition of 19.50 years (interquartile range, 23.00 years) were included. Fifty-two participants (54%) were manual wheelchair users. Interventions: Not applicable. Main Outcome Measures: Demographics information included age, sex, duration of health condition, height, weight, body mass index, and wheelchair type. To assess transfer quality, the Transfer Assessment Instrument versions 3.0 and 4.0 were used. The Spinal Cord Injury Falls Concern Scale was used to quantify FOF. Stepwise linear regression analysis was conducted to examine factors influencing FOF. Results: Participant's age, sex, duration of health condition, wheelchair type, and transfer quality were associated with FOF. The regression analysis indicated transfer quality (β=−0.25, P<.01) and wheelchair type (manual wheelchair, β=− 0.32, P<.01) were significant predictors of FOF, R²=20% (F=11.19; P<.01). Conclusions: Compared with manual wheelchair users, power wheelchair/scooter users with poor transfer quality reported higher levels of FOF. Clinicians and researchers working with wheelchair users should emphasize quality of transfers and consider the type of wheelchair while developing interventions to reduce FOF in this population. Further longitudinal prospective studies on modifiable factors associated with FOF among full-time wheelchair users are warranted.