Injurious Falls Among Individuals Prescribed Lower Limb Orthoses: Relationships with Mobility, Pain Interference, Lower Limb Strengh, Sex and Age

Background and/or Objectives: The broader population of individuals requiring lower limb orthoses has only recently been investigated, establishing a health profile of reduced physical function and increased pain interference. While populations frequently managed with lower limb orthoses, including those with stroke, multiple sclerosis and spinal cord injury, have reports of elevated rates of injurious falls, the rate of injurious falls has not been reported for the broader population. Potential correlates to higher fall rates may include reduced mobility, increased pain interference, reduced lower limb strength, sex and age.

Design: Retrospective analysis of multi-center data-base.

Setting : National Provider of Lower Limb Orthotic Rehabilitation

Participants : Individuals aged 18 and over prescribed a new or replacement lower limb orthosis

Interventions: Standardized outcomes collected during routine orthotic care

Main Outcome Measures: Injurious falls experienced over the preceding 6 months, Mobility as measured by OPRO-M T-score, Pain Interference as measured within PROMIS, Lower Limb Strength as measured using Motricity Index.

Results: Full data sets were identified for 1296 individuals with a 19% incidence of injurious falls over the preceding 6 months. Low and Modest Mobility levels were associated with an adjusted OR of 1.97 and 1.73 for injurious falls compared to above average mobility. Very high, high, and moderate levels of pain interference were associated with an adjusted OR of 2.45, 2.01 and 1.89 compared to below average pain interference levels. Reduced lower limb strength was associated with an adjusted OR of 1.49 relative to higher lower limb strength. Women had an adjusted OR of 1.44 relative to Men. Age over 65 had a non-significant adjusted OR of 1.17 relative to younger ages.

Conclusions: The present study is the first to report injurious fall rates among individuals prescribed lower limb orthoses. The rate was concerningly high at 19%. Reduced mobility, elevated pain interference, lower limb weakness and female sex were all associated with increased fall rates.