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Fall Injuries Associated with Use of Assistive Devices

Posted Nov 12 2009 10:02pm

walker The National Electronic Injury Surveillance System All Injury Program, supported by the Centers for Disease Control, tracks data from a representative sample of hospital emergency departments (EDs).  This dataset was recently analyzed 1 to reveal the circumstances of injurious falls and the assistive devices that were involved, yielding estimates that:

  • Each year in the US there are 47,312 nonfatal fall injury ED visits associated with the use of canes and walkers by people 65+ years of age;  60% of these happen at home.
  • The injuries sustained in these falls are serious with one-third of patients requiring hospital admission for fractures, contusions, abrasions & internal injury.  Men are more likely to sustain head and neck injuries while women more commonly injure the lower trunk.

Canes are generally prescribed for a moderate level of gait instability, whereas walkers are recommended for more generalized weakness, limited weight bearing ability or poor balance.  Women are more likely to use walkers than men.  Even though there are twice as many older adult cane-users as walker-users, this analysis found that:

  • Walkers are associated with 7 times as many ED fall injury visits as canes.
  • Women are 2 ½ times more likely to report to the ED for these walker-fall injuries.
  • Those 85+ years of age on a walker are at particularly high risk.

Clinical implications:  Assistive device use is associated with injurious falls that require medical care.  It is essential that older adults receive instruction from qualified therapists who can intervene to reduce intrinsic risk factors (poor balance) as well as maximize the likelihood of  proper fit and safe use of assistive devices.  Particular attention should be given to those helping those aged 85+ master the physical and cognitive skills required for safe walker use.

1.  Stevens JA, PhD, Thomas K, The L, ABJ, and Greenspan AI. (2009). Unintentional fall injuries associated with walkers and canes in older adults treated in US emergency departments.  JAGS 57:1464–1469.

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