Falling in the lives of adults with Cerebral Palsy: Taking action to prevent, manage, and support through the life course.

Development work questions What are the causes and consequences of falling and concern about falling (CaF) for Adults with Cerebral Palsy (AwCP)? Building on an evidence-based falls prevention programme what are the components of a fall prevention programme for adults with AwCP across the life course? Background In the UK, approximately 2.29 per 1000 live births result in CP and AwCP have lifelong impairments and experience approximately 5 times more falls than those without CP. While the original damage to the infant brain is non-progressive, AwCP will experience premature ageing and deterioration across musculoskeletal, functional and neurological systems. NICE guidelines (2019) state physiotherapy and occupational therapy for AwCP should be a high priority, yet there is a significant increase in unmet need. Falls/CaF restrict AwCP s roles and responsibilities in the workplace, family and community, and can cause psychological trauma. There is evidence that falls can be reduced (Action Falls reduced falls by 43% in care home residents). It is essential we have a falls prevention programme relevant to AwCP. Aims a) Understand the experiences and consequences of falling/CaF, b) Make an intervention such as the Action Falls intervention appropriate for AwCP. Objectives: Understand where and what global evidence is available about falls prevention strategies and programmes for people with CP. Collect first-hand accounts about a) the causes, consequences of falling/CaF b) possible strategies and interventions used to prevent falls for AwCP. Produce an educational film about causes and consequences of falls and strategies for prevention. Bring together stakeholders to discuss the project results and prepare for the programme of research to evaluate Development work plan The scoping review will answer the questions: What is the social, physical and psychological impact of falls? What strategies and interventions are used to manage falls, recovery and impact for AwCP? 25 life course interviews with AwCP to understand the interactions between social structures and individual embodiment which influence: a) causes and consequences of falling/CaF; b) falls management and prevention, c) changes in life choices and responsibilities; d) access to and utilisation of rehabilitation. 15 interviews with a range of practitioner experts will explore their perspectives on a) physical and emotional consequences of falling/CaF; b) help offered to clients who presents with history/risk/CaF; c) successful prevention or support strategies. Educational film, using clips from interviews to highlight what works, what is challenging/needed. Stakeholder event with practitioners, AwCP and family to discuss the evidence, including the film, and identify components to include in a subsequent intervention. Timelines for delivery Jan 25-Aug 25 Scoping review Oct 25 Submit scoping paper April 25-Oct 26 Interviews and analysis June 26 Submit empirical paper Mar-Aug 26 Educational film Sept-Dec 26 Stakeholder event Anticipated Impact and Dissemination The results will be disseminated through an end-of-study event and published in the International Journal of Rehabilition Research, and BMJOpen. The educational film will be hosted by Bobath and Scope on their websites. The anticipated impact will be an increased awareness across health and social care and the public about falls in AwCP.