When a child needs crutches, a walker, or a wheelchair to get around, such mobility aids should help instead of hurt. However, new research led by a team at the Center for Injury Research and Policy (CIRP) at The Research Institute at Nationwide Children’s Hospital, Columbus, Ohio, has found that more than 3,500 pediatric injuries per year are linked to these devices, with more than 63,000 such injuries showing up in U.S. emergency rooms between 1991 and 2008. The annual number of such cases also increased 23 percent during the 19-year study period. The data was gleaned from reports cached in the National Electronic Injury Surveillance System (NEISS), a database maintained by the U.S. Consumer Product Safety Commission (CPSC)that provides information on consumer product-related and sports and recreation-related injuries treated in hospital emergency departments nationwide.
Results of the study, published in Pediatrics as an early release online and in the journal’s June print issue, showed that 60 percent of pediatric mobility aid-related injuries occurred at home, and that injury patterns varied by the type of mobility aid. For example, children who used crutches were more likely to sustain limb injuries and to be diagnosed with a strain or a sprain; children who used walkers or wheelchairs, on the other hand, had a higher risk for head injuries, were three times more likely to be diagnosed with a traumatic brain injury (TBI), and had a higher likelihood of being hospitalized for their injuries.
“The associations between injury characteristics and type of mobility aid may be a result of the limitations of the children who were using the various aids,” theorized lead author Lara McKenzie, PhD, principal investigator at CIRP. “Crutch users typically have fewer cognitive, stability, and functional limitations than walker and wheelchair users. Likewise, children who fall while using crutches may be able to catch themselves with their feet or hands more easily than those who fall while using walkers or wheelchairs, thereby preventing injuries to the head but leading to more upper-extremity injuries.”
The research team also found distinct age-associated patterns of mobility aid-related injury. Children age ten and younger, who made up 42 percent of all cases, were more likely to injure their heads and sustain TBIs. Children ages 11-19 were more likely to injure their lower limbs and to sustain sprains or strains. The risk for transfer-related injuries, which NEISS defines as injuries that occur when children are moving from one activity to another, such as getting in or out of the car or the bathtub, was also greater for older children. This, the study reported, is likely because older children may be more difficult for caregivers to lift or carry. The study also examined injuries that resulted from misusing mobility aids, such as when children try a friend’s crutches or stand in a wheelchair. Misuse-related injuries occurred in eight percent of all cases, and crutches were most commonly involved.
“Additional research is essential for identifying injury prevention strategies that are specific to the pediatric population and the particular mobility aids,” McKenzie added. “Research on the underlying conditions and reasons for pediatric mobility aid use may expand the understanding of these injury patterns.”
According to CIRP, the report is the first published study to describe the incidence, patterns, and trends of mobility aid-related injuries to children and adolescents treated in U.S. emergency departments over the past two decades.