The Modification Of Morse Fall Scale And Study Of Reliability And Validity Of Modified Scale Used On Patients With SCI

Background:During rehabilitation,the Spinal Cord Injury(SCI)patients have to be trained for using wheelchairs,bed-wheelchair transfer as well as standing or walking.It was known that the fall risk for the SCI patients was three times higher than healthy people.Fall could cause brain damage,fractures,and frequently led to secondary spinal injury.Assessing the risk factors of fall had been recognized as one of the effective methods and was a necessary precautionary measure.Currently,though Lots of tools are used to assess the risk of falls,less of which can be used for the SCI patient.The reliability of Morse Fall Scale was higher,in which the assistive appliance and gait items could be adapted to SCI patients.However,items of the scale did not cover all the risk factors of fall in patients with spinal cord injury.Objective:(1)To modify the Chinese version of Morse Fall Scale into a fall risk assessing tool for SCI patients(2)To evaluate the reliability and validity of the modified version of Morse Fall Scale(mMFS).Methods:(1)The modification of Morse Fall Scale was started from June to September 2016 by a comprehensive literature review,combined with the retrospective investigation of fall events in SCI patients during rehabilitation period in our center.Then the fall risk factors were initially extracted and draft of modified scale was pretended by experts meeting.The opinions for the draft modified scale from 10 more experts were accumulated through consultation letters.At last,the mMFS was formed.(2)From October 2016 to August 2017,there were 1000 SCI patients evaluated by using the mMFS.The results were analyzed using SPSS20.0.The reliability and validity of the mMFS were tested.Results:(1)The mMFS consisted of 6 items.(2)As for the content validity,CVI was 0.9717.For the construct validity,three common factors that could explain the total variance 89.644%and the items were satisfied with the corresponding factors(>0.4).When the critical value was 50,the mMFS had a sensitivity of 92.1%,and a specificity of 61.6%.The areas under the ROC curve was 0.854(95%CI 0.808,0.900),(P<0.01).As for the inter-rater reliability of the mMFS,ICC was 0.969.The Cronbach's ? coefficient was 0.714.Conclusion:The mMFS had good reliability and validity and could be used to assess whether there is a risk of falls of hospitalized SCI patients during rehabilitation.